Provider Demographics
NPI:1386836872
Name:MAI-CHEN, OMD OFFICE
Entity Type:Organization
Organization Name:MAI-CHEN, OMD OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:PROF
Authorized Official - First Name:HUI FANG
Authorized Official - Middle Name:
Authorized Official - Last Name:MAI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:301-680-0756
Mailing Address - Street 1:12505 MONTCLAIR DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2052
Mailing Address - Country:US
Mailing Address - Phone:301-680-0756
Mailing Address - Fax:301-760-3427
Practice Address - Street 1:12505 MONTCLAIR DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2052
Practice Address - Country:US
Practice Address - Phone:301-680-0756
Practice Address - Fax:301-760-3427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00364171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty