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NPI Code Detail

MEDICARE: CHEN SU CHIUNG MD

MEDICARE:   CHEN  SU CHIUNG  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician33980MO

General Provider Information

NPI Number : 1649214370
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHEN SU CHIUNG MD
Provider Business Mailing Address
First Line : 3691 RUTGER ST
Second Line : PROVIDER ENROLLMENT
City : SAINT LOUIS
State : MO
Zip : 63110-2515
Country : US
Telephone Number : 314-977-6828
Fax Number : 314-977-6777
Provider Business Practice Location Address
First Line : 3691 RUTGER ST
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63110-2515
Country : US
Telephone Number : 314-977-6828
Fax Number : 314-977-6777
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 07/12/2007

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Directions to “ CHEN SU CHIUNG MD” Practice Location

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