Healthcare Provider Details

I. General information

NPI: 1588054670
Provider Name (Legal Business Name): SOK HUH DR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2015
Last Update Date: 07/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10412 PEARL ST
FAIRFAX VA
22032-3822
US

IV. Provider business mailing address

7700 LITTLE RIVER TPKE STE 100A-1
ANNANDALE VA
22003-2406
US

V. Phone/Fax

Practice location:
  • Phone: 703-677-0399
  • Fax:
Mailing address:
  • Phone: 703-296-7695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0121000672
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: