Provider Demographics
NPI:1962486456
Name:CHUNG, LUKE S (MD)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:S
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SOOIL
Other - Middle Name:
Other - Last Name:CHUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:13616 BARE ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-4111
Mailing Address - Country:US
Mailing Address - Phone:202-782-3208
Mailing Address - Fax:202-782-3075
Practice Address - Street 1:6825 16TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20306-0003
Practice Address - Country:US
Practice Address - Phone:202-782-3208
Practice Address - Fax:202-782-3075
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052289207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology