Provider Demographics
NPI:1285952002
Name:CHONG, BENNY YEE-CHUN (MD)
Entity type:Individual
Prefix:
First Name:BENNY
Middle Name:YEE-CHUN
Last Name:CHONG
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 1:200 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2982
Mailing Address - Country:US
Mailing Address - Phone:704-262-1642
Mailing Address - Fax:704-782-1826
Practice Address - Street 1:200 MEDICAL PARK DR
Practice Address - Street 2:SUITE 400
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2982
Practice Address - Country:US
Practice Address - Phone:704-786-1108
Practice Address - Fax:704-782-1826
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-00657208C00000X
FLME122679390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program