Provider Demographics
NPI:1467531343
Name:CHAW P.SUN.,M.D.P.C.
Entity Type:Organization
Organization Name:CHAW P.SUN.,M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHAW
Authorized Official - Middle Name:P
Authorized Official - Last Name:SUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-836-1213
Mailing Address - Street 1:9337 CALUMET AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2894
Mailing Address - Country:US
Mailing Address - Phone:219-836-1213
Mailing Address - Fax:219-836-1213
Practice Address - Street 1:9337 CALUMET AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2894
Practice Address - Country:US
Practice Address - Phone:219-836-1213
Practice Address - Fax:219-836-1213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01027634A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100167870AMedicaid
IN100167870AMedicaid
IN496140Medicare PIN