Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 220376 | MA |
NPI | 1770610909 |
---|---|
Provider Name | Jeannie Hye-Joon Chung |
First Address | Salem, MA 01970-2721 |
Second Address | Salem, MA 01970-2721 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 01/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3196615 | (05) | MA |
3631661 | US HEALTH (01) | MA |
469790 | TUFTS (01) | MA |
AA18695 | HARVARD PILGRIM (01) | MA |
CHJ28101 | BLUE CROSS BLUE SHIELD (01) | MA |
H90402 | (02) | MA |