Provider Demographics
NPI:1235126137
Name:CHUG, JOTESH S (MD)
Entity type:Individual
Prefix:DR
First Name:JOTESH
Middle Name:S
Last Name:CHUG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 DUFF AVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-5793
Mailing Address - Country:US
Mailing Address - Phone:515-239-6992
Mailing Address - Fax:515-239-3644
Practice Address - Street 1:1111 DUFF AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-5793
Practice Address - Country:US
Practice Address - Phone:515-239-6992
Practice Address - Fax:515-239-3644
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA35871208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0460840Medicaid
IA15099Medicare ID - Type Unspecified
IAI28624Medicare UPIN