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NPI Code Detail

MEDICARE: MAYLA FUNG CHUNG PA-C

MEDICARE: MAYLA FUNG CHUNG PA-C
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
1363A00000XPhysician Assistant0010-10887NC

General Provider Information

NPI Number : 1699386797
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYLA FUNG CHUNG PA-C
Provider Business Mailing Address
First Line : 5960 FAIRVIEW RD STE 500
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3113
Country : US
Telephone Number : 704-495-6334
Fax Number :
Provider Business Practice Location Address
First Line : 16817 MARVIN RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-2196
Country : US
Telephone Number : 704-495-6334
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2020
Last Update Date : 12/08/2025

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Directions to “ MAYLA FUNG CHUNG PA-C” Practice Location

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