Individual
TAE KAE CHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01039705A
IN
207RN0300X
Nephrology Physician
Primary
01039705A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100363470
—
IN
Enumeration date
09/16/2005
Last updated
10/10/2023
Update your record
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