Provider Demographics
NPI:1386819795
Name:CHUNG, RICHARD JOONOH (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOONOH
Last Name:CHUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 CIVIC CENTER BLVD
Mailing Address - Street 2:HUB, 14TH FLOOR, ADOLESCENT MEDICINE
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3820
Mailing Address - Country:US
Mailing Address - Phone:919-323-0809
Mailing Address - Fax:
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:919-323-0809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4842812080A0000X
NC128761208000000X
NC2011-00146208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine