Provider Demographics
NPI:1811122898
Name:ALBERT S.C. SUN, M.D., P.A.
Entity type:Organization
Organization Name:ALBERT S.C. SUN, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPIETOR
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:SHAN-CHING
Authorized Official - Last Name:SUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-877-1733
Mailing Address - Street 1:1716 HARFORD RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-2643
Mailing Address - Country:US
Mailing Address - Phone:410-877-1733
Mailing Address - Fax:410-877-1733
Practice Address - Street 1:1716 HARFORD RD
Practice Address - Street 2:SUITE 105
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047-2643
Practice Address - Country:US
Practice Address - Phone:410-877-1733
Practice Address - Fax:410-877-1733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-20
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0018779207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0400703OtherUNITED HEALTHCARE
1158241OtherCIGNA
455516OtherAETNA US HEALTHCARE
8401ASOtherCAREFIRST BCBS
843756OtherMAMSI PLAN
T769 0001OtherBLUE CHOICE CAREFIRST
2922OtherCOVENTRY HEALTHCARE
41527OtherCOVENTRY DIAMOND PLAN
T769 0001OtherFEDERAL BCBS
029023OtherJOHNS HOPKINS HEALTHCARE
0400703OtherUNITED HEALTHCARE FAMILY FIRST
MD250751000Medicaid
088380000OtherBLUE CROSS BLUE SHIELD PHN
2796OtherBRAVO HEALTH
9000437OtherPRUDENTIAL
98453-01OtherAMERIGROUP MARYLAND
98453-02OtherAMERIGROUP MARYLAND
029023OtherPRIORITY PARTNERS MCO
3725OtherMEDSTAR FAMILLY CHOICE
406291389OtherMEDICARE RAILROAD
2922OtherCOVENTRY HEALTHCARE
MD250751000Medicaid