Provider Demographics
NPI:1225090111
Name:HSU, MARCOS Y (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:MARCOS
Middle Name:Y
Last Name:HSU
Suffix:
Gender:M
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12904 DARNESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3518
Mailing Address - Country:US
Mailing Address - Phone:202-251-3221
Mailing Address - Fax:
Practice Address - Street 1:2200 KERNAN DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-6665
Practice Address - Country:US
Practice Address - Phone:410-448-6361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00865171100000X
DCNAT249175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD76923103OtherCAREFIRST BC/BS
MDEXEMPTMedicare UPIN