Provider Demographics
NPI:1780788224
Name:CHUSUEI, ORAPHAN CHOMTHONGDI (MD)
Entity type:Individual
Prefix:DR
First Name:ORAPHAN
Middle Name:CHOMTHONGDI
Last Name:CHUSUEI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8373A GREENSBORO DR
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3529
Mailing Address - Country:US
Mailing Address - Phone:703-821-6621
Mailing Address - Fax:703-356-0991
Practice Address - Street 1:8373A GREENSBORO DR
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3529
Practice Address - Country:US
Practice Address - Phone:703-821-6621
Practice Address - Fax:703-356-0991
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101023818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB94770Medicare UPIN
VACH415366Medicare ID - Type Unspecified