Provider Demographics
NPI:1821201898
Name:JUNG, MICHAEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:JUNG
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Gender:M
Credentials:MD
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Mailing Address - Street 1:55 FRUIT STREET
Mailing Address - Street 2:GRB 273A
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-726-8320
Mailing Address - Fax:617-724-3338
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:GRB 273A
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-8320
Practice Address - Fax:617-724-3338
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2011-04-13
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Provider Licenses
StateLicense IDTaxonomies
CAA949432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology