Provider Demographics
NPI:1083304166
Name:CHUN, NAM (PHARMD)
Entity Type:Individual
Prefix:
First Name:NAM
Middle Name:
Last Name:CHUN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:NAM
Other - Middle Name:
Other - Last Name:CHUN-YI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:17735 NEW HAMPSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTON
Mailing Address - State:MD
Mailing Address - Zip Code:20861-3631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2790 MACARTHUR RD
Practice Address - Street 2:
Practice Address - City:FORT MEADE
Practice Address - State:MD
Practice Address - Zip Code:20755-7033
Practice Address - Country:US
Practice Address - Phone:800-377-1723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40150183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist