Provider Demographics
NPI:1912933979
Name:CHUN, JUDY (MD)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:CHUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 AKERS FARM ROAD, NE
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073
Mailing Address - Country:US
Mailing Address - Phone:540-382-3440
Mailing Address - Fax:
Practice Address - Street 1:120 AKERS FARM ROAD, NE
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073
Practice Address - Country:US
Practice Address - Phone:540-382-3440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101234475208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VACF8401OtherRAILROAD MEDICARE
VA7504641Medicaid
VA0196190004Medicare NSC
NC006757P06Medicare PIN
VACF8401OtherRAILROAD MEDICARE
H88005Medicare UPIN
VA0196190002Medicare NSC