Provider Demographics
NPI:1619937083
Name:CHUN, CHINHAK (MD)
Entity Type:Individual
Prefix:
First Name:CHINHAK
Middle Name:
Last Name:CHUN
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 416
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02030
Mailing Address - Country:US
Mailing Address - Phone:508-653-3966
Mailing Address - Fax:508-655-7209
Practice Address - Street 1:67 UNION STREET
Practice Address - Street 2:SUITE 203A
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760
Practice Address - Country:US
Practice Address - Phone:508-653-3966
Practice Address - Fax:508-655-7209
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA56712207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3013391Medicaid
J05747Medicare ID - Type Unspecified
MA3013391Medicaid