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Individual

DR. EDWARD CHUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3333 SILAS CREEK PARKWAY, WINSTON-SALEM, NC 27103-3013
(336) 718-7080
(336) 718-9622
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 718-7080
(336) 718-9622

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200100662
NC
208M00000X
Hospitalist Physician
Primary
200100662
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110238891
RAILROAD MEDICARE
NC
01
1174510804
RAILROAD MEDICARE
NC
01
132F2
BLUECROSS BLUESHIELD
NC
05
89132F2
NC
05
N00663
SC
Enumeration date
09/27/2005
Last updated
10/25/2020
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