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General NPI Number Information
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NPI Number | 1598095853
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Entity Type | Individual
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Provider Name | HAESUN HWANG MS. RD. CDE.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2010
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Last Update Date | 06/02/2021
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Provider Practice Location Address
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Address Line | 6300 STEVENSON AVE SUITE D
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City | ALEXANDRIA
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State | VA
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Zip | 22304-3576
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Country | US
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Telephone | 571-295-5363
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Fax |
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Provider Business Mailing Address
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Address Line | 11432 CHARTRES WAY
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City | FAIRFAX
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State | VA
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Zip | 22030-0980
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Country | US
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Telephone | 571-274-1034
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 723491
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License Number State |
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