MEDICARE: DR. CYNTHIA HEEKYUNG JUN OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	TA1471	MD

General Provider Information

NPI Number	:	1184627366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA HEEKYUNG JUN OD

Provider Business Mailing Address
First Line	:	826 WASHINGTON RD
Second Line	:	STE 200
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-5750
Country	:	US
Telephone Number	:	410-876-3333
Fax Number	:	410-840-9133

Provider Business Practice Location Address
First Line	:	826 WASHINGTON RD
Second Line	:	STE 200
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-5750
Country	:	US
Telephone Number	:	410-876-3333
Fax Number	:	410-840-9133

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	01/12/2022

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