Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 01082693A | IN |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 01082693A | IN |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 57139 | AZ |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | BP10056953 | TX |
NPI | 1215215678 |
---|---|
Provider Name | Emily Taekyung Cha |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-5187 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2011 |
Last Update Date | 25/03/2021 |