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NPI Code Detail

MEDICARE: DR. JERRY CHUNG M.D

MEDICARE: DR. JERRY CHUNG M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0204XVascular & Interventional Radiology PhysicianA98189CA
22085R0202XDiagnostic Radiology PhysicianME101742FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184822231
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JERRY CHUNG M.D
Provider Business Mailing Address
First Line : 3600 MINNESOTA DR STE 800
Second Line :
City : EDINA
State : MN
Zip : 55435-7915
Country : US
Telephone Number : 952-595-1100
Fax Number :
Provider Business Practice Location Address
First Line : 3600 MINNESOTA DR STE 800
Second Line :
City : EDINA
State : MN
Zip : 55435-7915
Country : US
Telephone Number : 952-595-1100
Fax Number : 612-294-4903
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2007
Last Update Date : 02/02/2026

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Directions to “ DR. JERRY CHUNG M.D” Practice Location

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