Provider Demographics
NPI:1740572411
Name:CHEON, BO MYUNG (MD)
Entity Type:Individual
Prefix:MISS
First Name:BO MYUNG
Middle Name:
Last Name:CHEON
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 1:8515 CLEARWATER LN APT 302
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1581
Mailing Address - Country:US
Mailing Address - Phone:317-757-9961
Mailing Address - Fax:
Practice Address - Street 1:1130 W MICHIGAN ST
Practice Address - Street 2:FESLER HALL 204
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5209
Practice Address - Country:US
Practice Address - Phone:317-274-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01075039A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology