Provider Demographics
NPI:1164660510
Name:MING, MARLON (DPT)
Entity Type:Individual
Prefix:
First Name:MARLON
Middle Name:
Last Name:MING
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5252 LYNGATE CT
Mailing Address - Street 2:STE 203
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1673
Mailing Address - Country:US
Mailing Address - Phone:703-239-2300
Mailing Address - Fax:703-239-2301
Practice Address - Street 1:1101 OPAL CT
Practice Address - Street 2:SUITE 306
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5941
Practice Address - Country:US
Practice Address - Phone:301-790-3929
Practice Address - Fax:301-790-3926
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029799225100000X
IA004138225100000X
TX1184418225100000X
MD23107225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist