Provider Demographics
NPI:1356302822
Name:CHUN, NANCY S (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:S
Last Name:CHUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PROSPECT ST.
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060
Mailing Address - Country:US
Mailing Address - Phone:603-886-7900
Mailing Address - Fax:781-721-0725
Practice Address - Street 1:10 PROSPECT ST.
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060
Practice Address - Country:US
Practice Address - Phone:603-886-7900
Practice Address - Fax:781-279-3946
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204890207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3209181Medicaid
7827568OtherAETNA US HEALTHCARE
1886940OtherFIRST HEALTH
3185751OtherCIGNA HEALTH PLAN
410026OtherTUFTS HEALTH PLAN
J22310OtherBLUE SHIELD HMO BLUE
3209181OtherMEDICAID WELFARE
J22310OtherBLUE CARE ELECT
J22310OtherBLUE SHIELD INDEMNITY
042472266OtherPRIVATE HEALTHCARE SYSTEM
AA12434OtherHARVARD PILGRIM HEALTHCAR
042472266OtherONE HEALTH PLAN
042472266OtherTHREE RIVERS
0402086OtherEVERCARE
A30890OtherMEDICARE B
48388OtherFALLON COMMUNITY HEALTH P
784120OtherMVP HEALTH CARE
MAA30890Medicare ID - Type Unspecified
3209181OtherMEDICAID WELFARE