Provider Demographics
NPI:1760855563
Name:CHIN, JUNGWON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JUNGWON
Middle Name:
Last Name:CHIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JOYCE
Other - Middle Name:
Other - Last Name:CHIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3142 NORMANDY WOODS DR
Mailing Address - Street 2:APT F
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-4221
Mailing Address - Country:US
Mailing Address - Phone:919-280-6962
Mailing Address - Fax:
Practice Address - Street 1:10097 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-3611
Practice Address - Country:US
Practice Address - Phone:443-973-3339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23767183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist