Provider Demographics
NPI:1306835954
Name:CHYUNG, DENNIS KWAK (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:KWAK
Last Name:CHYUNG
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 1:4905 W TILGHMAN ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9130
Mailing Address - Country:US
Mailing Address - Phone:484-866-9583
Mailing Address - Fax:610-366-1147
Practice Address - Street 1:4905 W TILGHMAN ST
Practice Address - Street 2:SUITE 250
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9130
Practice Address - Country:US
Practice Address - Phone:484-866-9583
Practice Address - Fax:610-366-1147
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062814L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1077971OtherKEYSTONE MERCY
PA0679595000OtherINDEP. BLUE CROSS
PA1077971OtherAMERIHEALTH MERCY
PA0975360OtherKHP CENTRAL
PA975360OtherHIGHMARK
PA0016953150001Medicaid
PA01513965OtherGATEWAY
PA000000898636OtherTHREE RIVERS
PA975360OtherHIGHMARK
PA0975360OtherKHP CENTRAL
PA0016953150001Medicaid