DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: DR. WILLIS CLEMENT CHUNG M.D.

MEDICARE: DR. WILLIS CLEMENT 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
12085R0202XDiagnostic Radiology PhysicianP3700TX
22085R0202XDiagnostic Radiology Physician33420CO
32085N0700XNeuroradiology Physician64006MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2P00002241OTHERCORR MCRE MIC
3P00031103OTHERCORR MCRE RIA
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659357804
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIS CLEMENT CHUNG M.D.
Provider Business Mailing Address
First Line : 7595 ANAGRAM DR
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55344-7399
Country : US
Telephone Number : 612-573-2200
Fax Number : 612-573-2274
Provider Business Practice Location Address
First Line : 7595 ANAGRAM DR
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55344-7399
Country : US
Telephone Number : 612-573-2200
Fax Number : 612-573-2274
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2005
Last Update Date : 01/08/2025

Similar Medicare Providers

1275022618 — SAMANTHA ANNA WLOCH PHYSICIAN ASSISTANT
Practice Location Address:
7595 ANAGRAM DR
EDEN PRAIRIE, MN
55344-7399
Practice Phone: 612-573-2200
Practice Fax: 612-573-2274
1083024830 — DR. ALEXANDER YOWEI SHEU MD
Practice Location Address:
7595 ANAGRAM DR
EDEN PRAIRIE, MN
55344-7399
Practice Phone: 612-573-2200
Practice Fax: 612-573-2274
1598759193 — CHRISTINA MARIE BRAATZ MSN, RN, CNP
Practice Location Address:
7595 ANAGRAM DR
EDEN PRAIRIE, MN
55344-7399
Practice Phone: 612-573-2200
Practice Fax: 612-573-2274
1689660276 — DR. LISA A MILLER MD
Practice Location Address:
7595 ANAGRAM DR
EDEN PRAIRIE, MN
55344-7399
Practice Phone: 612-573-2200
Practice Fax: 612-573-2274
1770571457 — HUY Q TRAN MD
Practice Location Address:
7595 ANAGRAM DR
EDEN PRAIRIE, MN
55344-7399
Practice Phone: 612-573-2200
Practice Fax: 612-573-2274
1528058070 — DANIEL MARK GOLDING MD
Practice Location Address:
7595 ANAGRAM DR
EDEN PRAIRIE, MN
55344-7399
Practice Phone: 612-573-2200
Practice Fax: 612-573-2274

Directions to “ DR. WILLIS CLEMENT CHUNG M.D.” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.