Healthcare Provider Details

I. General information

NPI: 1487737193
Provider Name (Legal Business Name): UEI K CHUNG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 WINCOPIN CIR APT 417
COLUMBIA MD
21044-3454
US

IV. Provider business mailing address

10201 WINCOPIN CIR APT 417
COLUMBIA MD
21044-3454
US

V. Phone/Fax

Practice location:
  • Phone: 908-930-3513
  • Fax:
Mailing address:
  • Phone: 908-930-3513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number25MA03161500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: