MEDICARE: HONG JUN MD

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
1	208600000X	Surgery Physician	11969	ND
2	208600000X	Surgery Physician	0101242107	VA

General Provider Information

NPI Number	:	1689713620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HONG JUN MD

Provider Business Mailing Address
First Line	:	8580 MAGELLAN PKWY
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-1149
Country	:	US
Telephone Number	:	804-520-6730
Fax Number	:	804-520-6731

Provider Business Practice Location Address
First Line	:	40 MEDICAL PARK BLVD STE B
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23805-9289
Country	:	US
Telephone Number	:	804-520-6730
Fax Number	:	804-520-6731

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	02/05/2020

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Directions to “ HONG JUN MD” Practice Location

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