Healthcare Provider Details

I. General information

NPI: 1871772897
Provider Name (Legal Business Name): AIPING CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2007
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 S FREDERICK AVE SUITE 200
GAITHERSBURG MD
20877-1275
US

IV. Provider business mailing address

604 S FREDERICK AVE SUITE 200
GAITHERSBURG MD
20877-1275
US

V. Phone/Fax

Practice location:
  • Phone: 240-404-6423
  • Fax: 240-404-6426
Mailing address:
  • Phone: 240-404-6423
  • Fax: 240-404-6426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0061924
License Number StateMD

VIII. Authorized Official

Name: MR. AIPING SUI
Title or Position: OWNER
Credential: MD
Phone: 240-404-6423