Provider Demographics
NPI:1073101036
Name:DONG, SHUQI (LAC)
Entity Type:Individual
Prefix:MR
First Name:SHUQI
Middle Name:
Last Name:DONG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15200 SHADY GROVE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3169
Mailing Address - Country:US
Mailing Address - Phone:240-584-9539
Mailing Address - Fax:
Practice Address - Street 1:15200 SHADY GROVE RD STE 204
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3169
Practice Address - Country:US
Practice Address - Phone:240-584-9539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU02728OtherACUPUNCTURISTS