Keun Sam Chung MD

NPI 1821073107

Information of Keun Sam Chung MD

The NPI 1821073107 is an Individual type. NPI No 1821073107 belongs to Keun Sam Chung. Keun Sam Chung MD specializes in Anesthesiology. He is practising at 20 York St, New Haven, Connecticut 06504. You can also contact him via phone number (203) 785-2802.

Practice address located

  • 20 York St
  • New Haven, Connecticut 06504
  • (203) 785-2802
  • (203) 785-2802

Mailling address located

  • Po Box 9805
  • New Haven, Connecticut 06536
  • Not available
  • Not available
Keun Sam Chung MD is PECOS enrolled.
NPI No 1821073107
  • NPI number: 1821073107
  • NPI provider name: Keun Sam Chung MD
  • Gender: Male
  • NPI type: Individual
  • Sole Proprietor: No
  • Is Organization Subpart?: Yes
  • Enumeration date: Friday, December 9 2005
  • Last update date: Friday, December 9 2005
Primary Taxonomy
  • Taxonomy Code: 207L00000X
  • Classification: Anesthesiology
  • License Number: 018808
  • License State: Connecticut
Specialty of the provider
PrimaryTaxonomy CodeClassificationLicense NumberLicense State
No207L00000XAnesthesiology018808Connecticut
Yes207LP2900XPain Medicine018808Connecticut
Identifier for this provider
StateIdentifierTypeIssuer
CT001188085Medicaidn/a
CT050000071Medicare ID-Type Unspecifiedn/a
CT72000000Medicare ID-Type Unspecifiedn/a
n/aD02999Medicare UPINn/a
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