Individual
KEUN SAM CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20 YORK ST, YNHH TOMPKINS BUILDING 3RD FLOOR, NEW HAVEN, CT 06504-8900
(203) 785-2802
(203) 785-6664
Mailing address
PO BOX 9805, 300 GEORGE STREET 6TH FLOOR, NEW HAVEN, CT 06536-0805
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
018808
CT
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
018808
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001188085
—
CT
Enumeration date
12/09/2005
Last updated
06/25/2008
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