Provider Demographics
NPI:1639108442
Name:SUN, CHEN-CHIH J (MD)
Entity Type:Individual
Prefix:DR
First Name:CHEN-CHIH
Middle Name:J
Last Name:SUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 64592
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4592
Mailing Address - Country:US
Mailing Address - Phone:410-328-5555
Mailing Address - Fax:410-328-0929
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:NBW73
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:667-214-1608
Practice Address - Fax:410-328-0929
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020459207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCA9059Medicare PIN
MDC035Medicare PIN
MD220017398Medicare PIN
MDE15178Medicare UPIN