Keven Robert Chung, M.D.

Individual provider Active NPI Emergency Medicine Physician · Marion, NC

NPI 1124068226 · NPPES record last updated Jul 23, 2007

Key facts

NPI
1124068226
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Medicine Physician 207P00000X
License
22221 (NC)
Practice address
100 Rankin Dr
Marion, NC 28752-4989
Phone
(828) 659-5000
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22221NCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine Past Accepting new patients
McDowell Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 22221 NC Yes

Addresses

Primary practice location

100 Rankin Dr
Marion, NC 28752-4989

Mailing address

1431 Centerpoint Blvd
Suite 100
Knoxville, TN 37932-1984

Other identifiers

IdentifierTypeStateIssuer
8922496MedicaidNC

Other providers in Marion, NC

All providers in Marion, NC · Emergency Medicine Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.