Provider Demographics
NPI:1881898104
Name:CHUNG, YOUNHO (MD)
Entity type:Individual
Prefix:DR
First Name:YOUNHO
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 1:497 COLUMBIA AVE E STE 13
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5463
Mailing Address - Country:US
Mailing Address - Phone:269-969-6060
Mailing Address - Fax:269-965-7710
Practice Address - Street 1:497 COLUMBIA AVE E STE 13
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5463
Practice Address - Country:US
Practice Address - Phone:269-969-6060
Practice Address - Fax:269-965-7710
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301069853207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3464952Medicaid
MIP15870001Medicare ID - Type Unspecified
MIG73664Medicare UPIN