Chung, Keun Sam
Chung, Keun Sam is an individual health care provider with primary practice located at 20 York St Ynhh Tompkins Building 3Rd Floor, New Haven CT 06504-8900. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Chung, Keun Sam can be contacted via phone (203) 785-2802.Contact Information
Primary practice address
20 York St Ynhh Tompkins Building 3Rd Floor
New Haven CT 06504-8900
Phone: (203) 785-2802
Fax: (203) 785-6664
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 018808 | Connecticut |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | 018808 | Connecticut |
Profile Details
| NPI number | 1821073107 |
|---|---|
| LBN Legal business name | Chung, Keun Sam |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 9th, 2005 |
| Last updated | Jun 25th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821073107 | NPPES |
| Connecticut | MEDICAID | 001188085 |
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