Basic Information
| Provider Information | |||||||||
| NPI: | 1538103296 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MICHAEL S. CHUNE DO INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 643297 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452643297 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004518186 | ||||||||
| FaxNumber: | 9372912962 | ||||||||
| Practice Location | |||||||||
| Address1: | 7901 SCHATZ POINTE DR | ||||||||
| Address2: | STE. B | ||||||||
| City: | DAYTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454593856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9372910386 | ||||||||
| FaxNumber: | 9372912254 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2006 | ||||||||
| LastUpdateDate: | 10/05/2009 | ||||||||
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| AuthorizedOfficialLastName: | CHUNE | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9372910386 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 208800000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 0864364 | 05 | OH | MEDICAID | 1538103296 | 01 | OH | RAILROAD MEDICARE | OTHER |