Provider Demographics
NPI:1023873502
Name:ABC PEDIATRIC URGENT CARE PLLC
Entity type:Organization
Organization Name:ABC PEDIATRIC URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-248-1948
Mailing Address - Street 1:23634 STRICKLAND DR STE 110
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-7727
Mailing Address - Country:US
Mailing Address - Phone:703-687-6822
Mailing Address - Fax:703-239-7083
Practice Address - Street 1:23634 STRICKLAND DR STE 200
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-7725
Practice Address - Country:US
Practice Address - Phone:703-687-6822
Practice Address - Fax:703-239-7083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency MedicineGroup - Multi-Specialty