Basic Information
| Provider Information | |||||||||
| NPI: | 1912130469 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHUNG | ||||||||
| FirstName: | ELANE | ||||||||
| MiddleName: | HYUN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | POB 980257 1200 E. BROAD ST | ||||||||
| Address2: | DEPT OF GRADUATE MEDICAL EDUCATION - WEST HOSPITAL, W6S | ||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232980257 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8048289783 | ||||||||
| FaxNumber: | 8048285613 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 EAST JACKSON ST | ||||||||
| Address2: | DEPT LEGAL MEDICINE (PATHOLOGY) | ||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 23219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8047863176 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2009 | ||||||||
| LastUpdateDate: | 07/29/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.