Healthcare Provider Details

I. General information

NPI: 1760592844
Provider Name (Legal Business Name): ALBERT C HSU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19735 GERMANTOWN RD SUITE 200
GERMANTOWN MD
20874
US

IV. Provider business mailing address

4620 HORNBEAM DRIVE
ROCKVILLE MD
20853
US

V. Phone/Fax

Practice location:
  • Phone: 301-540-0811
  • Fax:
Mailing address:
  • Phone: 301-929-1234
  • Fax: 301-929-1238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0012854
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: