Provider Demographics
NPI:1518609866
Name:CHUN, QIN
Entity Type:Individual
Prefix:
First Name:QIN
Middle Name:
Last Name:CHUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3470 OLNEY LAYTONSVILLE RD STE 182
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1734
Mailing Address - Country:US
Mailing Address - Phone:301-615-0466
Mailing Address - Fax:301-615-0466
Practice Address - Street 1:17840 SHOTLEY BRIDGE PL
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1672
Practice Address - Country:US
Practice Address - Phone:301-615-0466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22-159246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant