Healthcare Provider Details

I. General information

NPI: 1316380421
Provider Name (Legal Business Name): MOSHE CHINN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11700 GAINSBOROUGH RD
POTOMAC MD
20854-3246
US

IV. Provider business mailing address

11700 GAINSBOROUGH RD
POTOMAC MD
20854-3246
US

V. Phone/Fax

Practice location:
  • Phone: 301-467-1302
  • Fax:
Mailing address:
  • Phone: 301-467-1302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD042920
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMD042920
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: