Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 47407 | WI |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 01071502A | IN |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | A102629 | CA |
NPI | 1679522437 |
---|---|
Provider Name | Karen S. Myung |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-5233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 06/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000776435 | ANTHEM PIN (01) | IN |
201079270 | (05) | IN |