Provider Demographics
NPI:1295758191
Name:CHUNG, JUN K (MD)
Entity type:Individual
Prefix:DR
First Name:JUN
Middle Name:K
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5838 HARBOUR VIEW BLVD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-2663
Mailing Address - Country:US
Mailing Address - Phone:757-541-1050
Mailing Address - Fax:757-541-1097
Practice Address - Street 1:5838 HARBOUR VIEW BLVD
Practice Address - Street 2:SUITE 270
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2663
Practice Address - Country:US
Practice Address - Phone:757-541-1050
Practice Address - Fax:757-541-1097
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2011-02-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101055897207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5804582Medicaid
VA5804582Medicaid
VAE89597Medicare UPIN
VA00X993M04Medicare PIN