Healthcare Provider Details

I. General information

NPI: 1851304083
Provider Name (Legal Business Name): FAITH E. CHIN D.P.M
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6939 GEORGIA AVE NW SUITE 103
WASHINGTON DC
20012-2456
US

IV. Provider business mailing address

11636 STEWART LN APT. 204
SILVER SPRING MD
20904-2485
US

V. Phone/Fax

Practice location:
  • Phone: 202-882-0288
  • Fax: 202-882-0285
Mailing address:
  • Phone: 301-680-8896
  • Fax: 301-680-8896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number774000509
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: