Provider Demographics
NPI:1033444765
Name:CHA, SUNG SOOK (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNG
Middle Name:SOOK
Last Name:CHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 N EAGLE CHASE DR
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:FL
Mailing Address - Zip Code:34442-6160
Mailing Address - Country:US
Mailing Address - Phone:352-527-8554
Mailing Address - Fax:
Practice Address - Street 1:1850 N EAGLE CHASE DR
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:FL
Practice Address - Zip Code:34442-6160
Practice Address - Country:US
Practice Address - Phone:352-527-8554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108309208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics