Healthcare Provider Details

I. General information

NPI: 1376572032
Provider Name (Legal Business Name): EDWARD HYUN CHUNG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5210 LINTON BLVD SUITE 103
DELRAY BEACH FL
33484-6542
US

IV. Provider business mailing address

5210 LINTON BLVD SUITE 103
DELRAY BEACH FL
33484-6542
US

V. Phone/Fax

Practice location:
  • Phone: 561-381-4271
  • Fax:
Mailing address:
  • Phone: 561-381-4271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberME98594
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: