Individual provider · NPI-1

Song Suck Chung, MD

Obstetrics & Gynecology, Gynecology · Glen Burnie, MD

NPI number1700968047
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1700968047
Entity type
Individual (NPI-1)
Name
Mr. Song Suck Chung
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Oct 19, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207VG0400X Obstetrics & Gynecology, GynecologyD14172MDYes

Practice location

1412 N Crain Hwy
Suite 6a
Glen Burnie, MD 21061-9306

Phone 410-582-9292 · Fax 410-582-9295

Mailing address

Po Box 558
Stevenson, MD 21153-0558

Phone 410-582-9292 · Fax 410-582-9295

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