Provider Demographics
NPI:1205842655
Name:CHUNG, JOSEPH Y (MD)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:Y
Last Name:CHUNG
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 1:31 E MEDICAL CT
Mailing Address - Street 2:STE B
Mailing Address - City:MARION
Mailing Address - State:NC
Mailing Address - Zip Code:28752
Mailing Address - Country:US
Mailing Address - Phone:828-652-5818
Mailing Address - Fax:828-659-8400
Practice Address - Street 1:31 E MEDICAL CT
Practice Address - Street 2:STE B
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752
Practice Address - Country:US
Practice Address - Phone:828-652-5818
Practice Address - Fax:828-659-8400
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17851208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8922484Medicaid
22484OtherBCBS
C80635Medicare UPIN
201374Medicare ID - Type Unspecified