Tae Hong Chung, MD, PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

TC035184 Issued in MI

Legal business name

TAE HONG CHUNG, MD, PC

Practice address

2700 Pointe Tremble Rd
Algonac, MI 48001-1836

Phone

(810) 794-9324

Fax

(810) 794-0705

NPI assigned

Oct 9, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tae Hong Chung, M.D.

Title

Owner

Phone

(810) 794-9324

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1487842142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 POINTE TREMBLE RD",
            "city": "ALGONAC",
            "state": "MI",
            "postal_code": "480011836",
            "telephone_number": "810-794-9324",
            "fax_number": "810-794-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 POINTE TREMBLE RD",
            "city": "ALGONAC",
            "state": "MI",
            "postal_code": "480011836",
            "telephone_number": "810-794-9324",
            "fax_number": "810-794-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAE HONG CHUNG, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "CHUNG",
        "authorized_official_first_name": "TAE",
        "authorized_official_middle_name": "HONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-794-9324",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "TC035184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2104149",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Algonac, MI
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.