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General NPI Number Information
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NPI Number | 1104071646
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Entity Type | Organization
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Legal Business Name | DR.ROH & SHIN'S CLINIC
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Dates
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Enumeration Date | 11/25/2008
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 5107 SILVER HILL RD
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City | SUITLAND
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State | MD
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Zip | 20746-5213
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Country | US
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Telephone | 301-568-1784
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Fax |
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Provider Business Mailing Address
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Address Line | 5107 SILVER HILL RD
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City | SUITLAND
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State | MD
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Zip | 20746-5213
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Country | US
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Telephone | 301-568-1784
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | YOUNG S SHIN
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Credential |
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Telephone | 301-568-1784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0023439
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License Number State | MD
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