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Organization
TAE JUNG M.D., INC.
Active
Organization
TAE JUNG M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAE HUI JUNG M.D. (PRESIDENT)
(330) 382-0388
Entity
Organization
Contact information
Practice address
15424 SPRUCEVALE RD, EAST LIVERPOOL, OH 43920-9200
(330) 382-0388
(330) 382-0389
Mailing address
15424 SPRUCEVALE RD, EAST LIVERPOOL, OH 43920-9200
(330) 382-0388
(330) 382-0389
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35078382J
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306021878
NPI GROUP NUMBER
OH
05
—
2205527
—
OH
01
—
SP00791
MEDICARE GROUP NUMBER
OH
Enumeration date
01/03/2008
Last updated
12/13/2013
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