MEDICARE: RICHARD TAM CHUNG M.D.

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	207R00000X	Internal Medicine Physician	34226	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	111077615	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	025461	OTHER	BCBS KS
3	02067022	OTHER	BCBS KC
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104981026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD TAM CHUNG M.D.

Provider Business Mailing Address
First Line	:	PO BOX 246
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64013-0246
Country	:	US
Telephone Number	:	816-229-9411
Fax Number	:	816-229-9411

Provider Business Practice Location Address
First Line	:	500 NW VESPER ST
Second Line	:
City	:	BLUE SPRINGS
State	:	MO
Zip	:	64014-2744
Country	:	US
Telephone Number	:	816-229-9411
Fax Number	:	816-229-9411

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

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	02/23/2010

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Directions to “ RICHARD TAM CHUNG M.D.” Practice Location

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