Provider Demographics
NPI:1629114392
Name:BYUN, TAESUN (DC)
Entity Type:Individual
Prefix:
First Name:TAESUN
Middle Name:
Last Name:BYUN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11921 ROCKVILLE PIKE
Mailing Address - Street 2:SUITE 411
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2737
Mailing Address - Country:US
Mailing Address - Phone:301-230-0082
Mailing Address - Fax:301-230-0084
Practice Address - Street 1:11921 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 411
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2737
Practice Address - Country:US
Practice Address - Phone:301-230-0082
Practice Address - Fax:301-230-0084
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02155111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor