Provider Demographics
NPI:1861672305
Name:CHANCHIEN, TSUNIE (MD)
Entity Type:Individual
Prefix:
First Name:TSUNIE
Middle Name:
Last Name:CHANCHIEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8824 CUNNINGHAM DR STE A
Mailing Address - Street 2:
Mailing Address - City:BERWYN HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20740-2338
Mailing Address - Country:US
Mailing Address - Phone:301-345-8616
Mailing Address - Fax:301-345-2779
Practice Address - Street 1:8824 CUNNINGHAM DR STE A
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2338
Practice Address - Country:US
Practice Address - Phone:301-345-8616
Practice Address - Fax:301-345-2779
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-13
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD13339 MD207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD115621700 MDMedicaid
MD12109OtherCAREFIRST OF MARYLAND
DC01780001OtherCAREFIRST OF DC
MD115621700 MDMedicaid
029904Medicare PIN