Provider Demographics
NPI:1093179400
Name:CHUANG, JUSTIN CHERNG (MD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:CHERNG
Last Name:CHUANG
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 1:28 CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:VT
Mailing Address - Zip Code:05468-3104
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CVMC HOSPITALIST DEPARTMENT
Practice Address - Street 2:130 FISHER ROAD, 3RD FLOOR
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9000
Practice Address - Country:US
Practice Address - Phone:802-225-1743
Practice Address - Fax:802-225-1745
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VT042-0014453207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program