Provider Demographics
NPI:1942462601
Name:CHONG, DANIEL GENE (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:GENE
Last Name:CHONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8613 LEE HWY # 200N
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2171
Mailing Address - Country:US
Mailing Address - Phone:703-208-3155
Mailing Address - Fax:703-280-9596
Practice Address - Street 1:8613 ROUTE 29 STE 200N
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2171
Practice Address - Country:US
Practice Address - Phone:715-350-8400
Practice Address - Fax:703-280-9596
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101257655207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1942462601Medicaid
DC429938ZAN3Medicare PIN