Provider Demographics
NPI:1164435103
Name:HUNG, PATRICK DEAN-TZO (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:DEAN-TZO
Last Name:HUNG
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 1:1593 YANCEYVILLE ST.
Mailing Address - Street 2:BUILDING A, SUITE 100
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-6948
Mailing Address - Country:US
Mailing Address - Phone:336-275-1306
Mailing Address - Fax:336-275-1307
Practice Address - Street 1:1593 YANCEYVILLE ST.
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6948
Practice Address - Country:US
Practice Address - Phone:336-275-1306
Practice Address - Fax:336-275-1307
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-00334207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1391COtherBCBS
NC806361OtherPARTNERS
NC2044598OtherMEDICARE INDIVIDUAL
NC2900502OtherUNITED HEALTHCARE
NC2134021OtherMAMSI
NC3958674OtherAETNA
NC561999974OtherTAX ID
NC5902476Medicaid
NCE3523OtherMEDCOST
NCP00287230OtherRAILROAD MEDICARE
NC2044598Medicare PIN
NC1391COtherBCBS