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Individual
SANGWON JUNG
Active
Individual
SANGWON JUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
502086
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404059700
—
MD
01
—
617750
CAREFIRST BCBS
MD
01
—
G7310001
CAREFIRST BCBS
DC
01
—
KDN25A
CAREFIRST BCBS
MD
Enumeration date
08/31/2006
Last updated
10/16/2007
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