Chae, Kyung Ai Mireille
Chae, Kyung Ai Mireille is an individual health care provider with primary practice located at 801 York St , Manitowoc WI 54220-4630. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Pediatric Dermatology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is her primary health care specialty. Chae, Kyung Ai Mireille can be contacted via phone (920) 683-5278.Contact Information
Primary practice address
801 York St
Manitowoc WI 54220-4630
Phone: (920) 683-5278
Fax: (920) 686-9674
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ND0900X | 67321-20 | Wisconsin |
| Allopathic & Osteopathic Physicians / Pediatric Dermatology | 207NP0225X | 67321-20 | Wisconsin |
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ZD0900X | 67321-20 | Wisconsin |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 67321-20 | Wisconsin |
Profile Details
| NPI number | 1932101060 |
|---|---|
| LBN Legal business name | Chae, Kyung Ai Mireille |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2005 |
| Last updated | Feb 15th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932101060 | NPPES |
| Minnesota | MEDICAID | 306311900 |
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