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NPI Code Detail

MEDICARE: MRS. RONGJUAN SUN L.AC.

MEDICARE:  MRS. RONGJUAN  SUN  L.AC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturistU00999MD

General Provider Information

NPI Number : 1780710533
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RONGJUAN SUN L.AC.
Provider Business Mailing Address
First Line : 5072 DORSEY HALL DR
Second Line : SUITE 103
City : ELLICOTT CITY
State : MD
Zip : 21042-7844
Country : US
Telephone Number : 410-948-3577
Fax Number : 410-715-3889
Provider Business Practice Location Address
First Line : 5072 DORSEY HALL DR
Second Line : SUITE 103
City : ELLICOTT CITY
State : MD
Zip : 21042-7844
Country : US
Telephone Number : 410-948-3577
Fax Number : 410-715-3889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. RONGJUAN SUN L.AC.” Practice Location

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