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General NPI Number Information
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NPI Number | 1760648745
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Entity Type | Individual
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Provider Name | MELISSA GRACE CHUNG MD
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Gender | Female
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Dates
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Enumeration Date | 07/30/2008
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 555 S 18TH ST
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City | COLUMBUS
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State | OH
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Zip | 43205-2654
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Country | US
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Telephone | 614-722-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 700 CHILDRENS DR
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City | COLUMBUS
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State | OH
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Zip | 43205-2664
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Country | US
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Telephone | 614-722-2000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 35.097301
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35.097301
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 35.097301
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | 35.097301
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License Number State | OH
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