Individual
MR. SONG SUCK CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1412 N CRAIN HWY, SUITE 6A, GLEN BURNIE, MD 21061-9306
(410) 582-9292
(410) 582-9295
Mailing address
PO BOX 558, STEVENSON, MD 21153-0558
(410) 582-9292
(410) 582-9295
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
D14172
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05740001
BLUE CHOICE
MD
01
—
KFJ3
BLUE CROSS BLUE SHIELD
MD
Enumeration date
10/19/2006
Last updated
07/08/2007
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