Provider Demographics
NPI:1164739967
Name:JUNG, ROBERT MARC (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:MARC
Last Name:JUNG
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:PO BOX 640
Mailing Address - Street 2:
Mailing Address - City:MANTEO
Mailing Address - State:NC
Mailing Address - Zip Code:27954-0640
Mailing Address - Country:US
Mailing Address - Phone:252-473-2282
Mailing Address - Fax:252-473-2282
Practice Address - Street 1:1032 PIRATES WAY
Practice Address - Street 2:
Practice Address - City:MANTEO
Practice Address - State:NC
Practice Address - Zip Code:27954-9466
Practice Address - Country:US
Practice Address - Phone:252-473-2282
Practice Address - Fax:252-473-2282
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT016012207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery