MEDICARE: DR. CHI-YUN HO M.D.

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
1	207V00000X	Obstetrics & Gynecology Physician	01026480	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000208804	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1699756163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHI-YUN HO M.D.

Provider Business Mailing Address
First Line	:	1542 S BLOOMINGTON ST
Second Line	:
City	:	GREENCASTLE
State	:	IN
Zip	:	46135-2212
Country	:	US
Telephone Number	:	765-655-2686
Fax Number	:	765-655-2687

Provider Business Practice Location Address
First Line	:	1542 S BLOOMINGTON ST
Second Line	:
City	:	GREENCASTLE
State	:	IN
Zip	:	46135-2212
Country	:	US
Telephone Number	:	765-655-2686
Fax Number	:	765-655-2687

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	07/13/2007

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