Provider Demographics
NPI:1083667141
Name:TUNG, PAUL C (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:C
Last Name:TUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:789 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2526
Mailing Address - Country:US
Mailing Address - Phone:603-742-1143
Mailing Address - Fax:603-749-3509
Practice Address - Street 1:10 MEMBERS WAY
Practice Address - Street 2:SUITE 400
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-5933
Practice Address - Country:US
Practice Address - Phone:603-742-1143
Practice Address - Fax:603-749-3509
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH7890207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1083667141Medicaid
NH3076045Medicaid
ME1083667141Medicaid
NHRE026501Medicare PIN