Provider Demographics
NPI:1063878494
Name:CHUN, PHILIP (RPH)
Entity type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:
Last Name:CHUN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 W BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223-1558
Mailing Address - Country:US
Mailing Address - Phone:410-362-3310
Mailing Address - Fax:410-362-5568
Practice Address - Street 1:2000 W BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-1558
Practice Address - Country:US
Practice Address - Phone:410-362-3310
Practice Address - Fax:410-362-5568
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14547183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist