Thomas S. Chung, M.D.
in Saint Louis, MO. Individual provider (NPI-1).
NPI number1962473751
StatusActive
Last updated in NPPESMar 11, 2024
Details
- NPI
- 1962473751
- Entity type
- Individual (NPI-1)
- Name
- Thomas S. Chung
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 30, 2006
- Certification date
- Mar 11, 2024
- Last updated
- Mar 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0001X | 2013012262 | MO | Yes | |
| 2085R0001X | 036-104163 | IL | ||
| 2085R0001X | A78262 | CA | ||
| 2085R0001X | 01067637A | IN |
Practice location
915 N Grand BlvdSaint Louis, MO 63106-1621
Phone 314-289-6324 · Fax 314-289-6322
Mailing address
Po Box 955534Saint Louis, MO 63195-5534
Other practice locations
1011 Bowles Ave Ste G50
Fenton, MO 63026-0562
Fenton, MO 63026-0562
Phone 636-496-4640
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