Healthcare Provider Details

I. General information

NPI: 1104752278
Provider Name (Legal Business Name): HONGJING SUN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 ALICEANNA ST APT 1821
BALTIMORE MD
21231-3272
US

IV. Provider business mailing address

1301 ALICEANNA ST APT 1821
BALTIMORE MD
21231-3272
US

V. Phone/Fax

Practice location:
  • Phone: 215-827-9606
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0205X
TaxonomyRadiological Physics Physician
License NumberNA
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: