MEDICARE: RICHARD 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	233471	MA

General Provider Information

NPI Number	:	1639344807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD CHUNG M.D.

Provider Business Mailing Address
First Line	:	3307 STATION CIR
Second Line	:
City	:	DEDHAM
State	:	MA
Zip	:	02026-7501
Country	:	US
Telephone Number	:	917-648-6639
Fax Number	:

Provider Business Practice Location Address
First Line	:	3307 STATION CIR
Second Line	:
City	:	DEDHAM
State	:	MA
Zip	:	02026-7501
Country	:	US
Telephone Number	:	917-648-6639
Fax Number	:

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

Provider Enumeration Date	:	04/28/2008
Last Update Date	:	08/16/2011

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

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