Provider Demographics
NPI:1689003071
Name:CHUNG, EVAN HOIYUP (DC, MS)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:HOIYUP
Last Name:CHUNG
Suffix:
Gender:M
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 N ROLLING RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4140
Mailing Address - Country:US
Mailing Address - Phone:410-747-1578
Mailing Address - Fax:410-747-1517
Practice Address - Street 1:516 N ROLLING RD
Practice Address - Street 2:SUITE 205
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4140
Practice Address - Country:US
Practice Address - Phone:443-315-5223
Practice Address - Fax:443-315-5128
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012410111N00000X
MDS03815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor