Basic Information
Provider Information
NPI: 1346479532
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUANG
FirstName: CHUN
MiddleName: CHIN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 E MCBEE AVE FL 4
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296012842
CountryCode: US
TelephoneNumber: 8645228603
FaxNumber: 4234952625
Practice Location
Address1: 200 PATEWOOD DR STE B350
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296156337
CountryCode: US
TelephoneNumber: 8644544500
FaxNumber: 8644544505
Other Information
ProviderEnumerationDate: 07/08/2009
LastUpdateDate: 02/28/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/28/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400X50226TNN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
2084N0400X87111SCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology

No ID Information.


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