Individual
CHARLES MYLAN CHUMAN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
297 W FRANCISCAN LANE, SUITE 207, CROWN POINT, IN 46307-4859
(219) 757-6410
(219) 757-6166
Mailing address
PO BOX 1009, CHESTERTON, IN 46304-0009
(219) 757-6410
(219) 757-6166
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
01035829
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000080236
ANTHEM
IN
01
—
0004048160
AETNA
IN
01
—
0091107960
ILLINOIS BLUE CROSS
IN
Enumeration date
07/12/2006
Last updated
09/30/2010
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