Healthcare Provider Details

I. General information

NPI: 1811122898
Provider Name (Legal Business Name): ALBERT S.C. SUN, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2009
Last Update Date: 08/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 HARFORD RD SUITE 105
FALLSTON MD
21047-2643
US

IV. Provider business mailing address

1716 HARFORD RD SUITE 105
FALLSTON MD
21047-2643
US

V. Phone/Fax

Practice location:
  • Phone: 410-877-1733
  • Fax: 410-877-1733
Mailing address:
  • Phone: 410-877-1733
  • Fax: 410-877-1733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0018779
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberD0018779
License Number StateMD

VIII. Authorized Official

Name: ALBERT SHAN-CHING SUN
Title or Position: SOLE PROPIETOR
Credential: M.D.
Phone: 410-877-1733