Provider Demographics
NPI:1598754723
Name:CHUNG, WILLIAM W (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:W
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3201 S 16TH ST
Mailing Address - Street 2:RM 1000
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-4537
Mailing Address - Country:US
Mailing Address - Phone:414-645-4240
Mailing Address - Fax:414-665-8240
Practice Address - Street 1:3201 S 16TH ST
Practice Address - Street 2:RM 1000
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-4537
Practice Address - Country:US
Practice Address - Phone:414-645-4240
Practice Address - Fax:414-665-8240
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI18854207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30921500Medicaid
WIB84773Medicare UPIN