MEDICARE: SANGWON JUNG DC

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	111N00000X	Chiropractor	502086	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G7310001	OTHER	DC	CAREFIRST BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	KDN25A	OTHER	MD	CAREFIRST BCBS
4	617750	OTHER	MD	CAREFIRST BCBS

General Provider Information

NPI Number	:	1326150194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANGWON JUNG DC

Provider Business Mailing Address
First Line	:	9020 OLD GEORGETOWN RD
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-1514
Country	:	US
Telephone Number	:	301-468-3434
Fax Number	:	240-223-2502

Provider Business Practice Location Address
First Line	:	9020 OLD GEORGETOWN RD
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-1514
Country	:	US
Telephone Number	:	301-468-3434
Fax Number	:	240-223-2502

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	10/16/2007

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Directions to “ SANGWON JUNG DC” Practice Location

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