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Organization
ACTIVE PODIATRY P.C.
Active
Organization
ACTIVE PODIATRY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YONG S. CHAE DPM (OWNER/PRESIDENT)
(317) 328-6622
Entity
Organization
Contact information
Practice address
1910 LAFAYETTE RD, CRAWFORDSVILLE, IN 47933-1037
(765) 362-7200
(765) 362-4870
Mailing address
1910 LAFAYETTE RD, CRAWFORDSVILLE, IN 47933-1037
(765) 362-7200
(765) 362-4870
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000857A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200178610B
—
IN
Enumeration date
01/11/2008
Last updated
01/27/2021
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