Individual
DR. MAURICE K CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
310 S CABLE RD, LIMA, OH 45805-3110
(419) 228-1000
(419) 227-3085
Mailing address
310 S CABLE RD, LIMA, OH 45805-3110
(419) 228-1000
(419) 227-3085
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
000330743I
OH
207VG0400X
Gynecology Physician
35058390
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0742307
—
OH
01
—
160019139
RR MEDICARE
OH
01
—
29189
ANTHEM
OH
01
—
P01387049
MEDICARE PTAN
OH
Enumeration date
08/19/2005
Last updated
01/25/2016
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