Individual
DR. AERIE CHUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3838 N MAIN ST STE 1C, MISHAWAKA, IN 46545-3100
(574) 404-3980
(574) 931-8601
Mailing address
3838 N MAIN ST STE 1C, MISHAWAKA, IN 46545-3100
(574) 404-3980
(574) 931-8601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301091941
MI
207RI0200X
Infectious Disease Physician
Primary
01072481A
IN
207RI0200X
Infectious Disease Physician
18339
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1877200008
MEDICARE
IN
05
—
201163410
—
IN
01
—
P01703901
RR MEDICARE
IN
Enumeration date
07/21/2008
Last updated
07/01/2023
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