Provider Demographics
NPI:1659487098
Name:MERRIFIELD OB/GYN. P.C.
Entity Type:Organization
Organization Name:MERRIFIELD OB/GYN. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HYUNKI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-204-0555
Mailing Address - Street 1:2826 OLD LEE HWY
Mailing Address - Street 2:SUITE 306
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4323
Mailing Address - Country:US
Mailing Address - Phone:703-204-0555
Mailing Address - Fax:703-204-0544
Practice Address - Street 1:2826 OLD LEE HWY
Practice Address - Street 2:SUITE 306
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4346
Practice Address - Country:US
Practice Address - Phone:703-204-0555
Practice Address - Fax:703-204-0544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101056854207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG02150M01Medicare PIN
VAI46226Medicare UPIN
VAG17303Medicare UPIN
VA018491M50Medicare PIN