Provider Demographics
NPI:1497101885
Name:SHIN, WOO HYUNG
Entity Type:Individual
Prefix:
First Name:WOO
Middle Name:HYUNG
Last Name:SHIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14606 SEASONS DR
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-6007
Mailing Address - Country:US
Mailing Address - Phone:703-591-3333
Mailing Address - Fax:
Practice Address - Street 1:4216 EVERGREEN LN STE 121
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3256
Practice Address - Country:US
Practice Address - Phone:703-591-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000777171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist