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General NPI Number Information
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NPI Number | 1336110113
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Entity Type | Individual
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Provider Name | KI YOUNG CHUNG MD
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Gender | Male
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 01/31/2018
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Provider Practice Location Address
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Address Line | 120 DILLON DR
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City | SPARTANBURG
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State | SC
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Zip | 29307-1018
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Country | US
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Telephone | 864-699-5700
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Fax | 864-699-5701
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Provider Business Mailing Address
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Address Line | 1 INDEPENDENCE PT STE 212
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City | GREENVILLE
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State | SC
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Zip | 29615-4536
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Country | US
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Telephone | 864-797-6303
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Fax | 864-797-6198
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 33366
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License Number State | SC
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