Provider Demographics
NPI:1912961871
Name:CHUNG, SUSIE N (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSIE
Middle Name:N
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 558
Mailing Address - Street 2:
Mailing Address - City:STEVENSON
Mailing Address - State:MD
Mailing Address - Zip Code:21153-0558
Mailing Address - Country:US
Mailing Address - Phone:410-337-9003
Mailing Address - Fax:410-337-9005
Practice Address - Street 1:120 SISTER PIERRE DR
Practice Address - Street 2:SUITE 303
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7516
Practice Address - Country:US
Practice Address - Phone:410-337-9003
Practice Address - Fax:410-337-9005
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0058472207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology