Provider Demographics
NPI:1538130646
Name:CHUNG, YUNJO (MD)
Entity Type:Individual
Prefix:
First Name:YUNJO
Middle Name:
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10190 SPRINGFIELD PIKE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45215-1448
Mailing Address - Country:US
Mailing Address - Phone:513-772-7600
Mailing Address - Fax:513-923-4301
Practice Address - Street 1:10190 SPRINGFIELD PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45215-1448
Practice Address - Country:US
Practice Address - Phone:513-772-7600
Practice Address - Fax:513-326-5572
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35033892207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH160030535OtherMEDICARE RAILROAD
OH0995446Medicaid
OHC01030Medicare UPIN
OH160030535OtherMEDICARE RAILROAD
OH0995446Medicaid