Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 35.090497 | OH |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 35.090497 | OH |
NPI | 1134320963 |
---|---|
Provider Name | Roy Chung |
First Address | Cleveland, OH 44195-0001 |
Second Address | Cleveland, OH 44195-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 29/03/2016 |