Individual
SAMUEL CHUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1631 HOSPITAL DR, SUITE 200, SANTA FE, NM 87505-4728
(505) 424-0200
(505) 424-6608
Mailing address
455 SAINT MICHAELS DR, PHYSICIAN PRACTICES, ATTN: CARLA GOMEZ, SANTA FE, NM 87505-7601
(505) 424-0200
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MD2003-0409
NM
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
2003-0409
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10005490
LOVELACE
—
05
—
14277204
—
NM
01
—
160999
UHC
—
01
—
201043508
PRESBYTERIAN HEALTH PLANS
—
01
—
2265066
CIGNA
—
01
—
834635
CCN
—
01
—
NM009P04
BCBS NM
NM
01
—
PROVP12469
MOLINA
—
Enumeration date
03/09/2006
Last updated
05/31/2011
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