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General NPI Number Information
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NPI Number | 1023873502
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Entity Type | Organization
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Legal Business Name | ABC PEDIATRIC URGENT CARE PLLC
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Dates
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Enumeration Date | 02/14/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 23634 STRICKLAND DR STE 200
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City | ASHBURN
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State | VA
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Zip | 20148-7725
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Country | US
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Telephone | 703-687-6822
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Fax | 703-239-7083
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Provider Business Mailing Address
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Address Line | 23634 STRICKLAND DR STE 110
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City | ASHBURN
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State | VA
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Zip | 20148-7727
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Country | US
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Telephone | 703-687-6822
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Fax | 703-239-7083
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Authorized Official
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Title or Position | CEO
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Name | EUGENE CHUNG
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Credential | MD
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Telephone | 571-248-1948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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