1912130469 NPI number — DR. ELANE HYUN CHUNG M.D.

Table of content: DR. ELANE HYUN CHUNG M.D. (NPI 1912130469)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912130469 NPI number — DR. ELANE HYUN CHUNG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHUNG
Provider First Name:
ELANE
Provider Middle Name:
HYUN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912130469
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
POB 980257 1200 E. BROAD ST
Provider Second Line Business Mailing Address:
DEPT OF GRADUATE MEDICAL EDUCATION - WEST HOSPITAL, W6S
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23298-0257
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-828-9783
Provider Business Mailing Address Fax Number:
804-828-5613

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 EAST JACKSON ST
Provider Second Line Business Practice Location Address:
DEPT LEGAL MEDICINE (PATHOLOGY)
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-786-3176
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/01/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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