Provider Demographics
NPI:1356677306
Name:HWANG H. JUNN MD IM/GERI PLC
Entity Type:Organization
Organization Name:HWANG H. JUNN MD IM/GERI PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:HWANG
Authorized Official - Middle Name:H
Authorized Official - Last Name:JUNN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-468-4462
Mailing Address - Street 1:4216 EVERGREEN LANE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3253
Mailing Address - Country:US
Mailing Address - Phone:703-468-4462
Mailing Address - Fax:703-256-4680
Practice Address - Street 1:4216 EVERGREEN LANE
Practice Address - Street 2:SUITE 111
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3253
Practice Address - Country:US
Practice Address - Phone:703-468-4462
Practice Address - Fax:703-256-4680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101242585261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty