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:
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Health care specialties

SpecialtyCodeLicense #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 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821073107 NPPES
Connecticut MEDICAID 001188085

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