1558348821 NPI number — CHANG CHING D LIN M.D.

Table of content: CHANG CHING D LIN M.D. (NPI 1558348821)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558348821 NPI number — CHANG CHING D LIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIN
Provider First Name:
CHANG CHING
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558348821
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/24/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8555 16TH ST
Provider Second Line Business Mailing Address:
SUITE 310
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20910-2816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-562-7200
Provider Business Mailing Address Fax Number:
301-563-7199

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 SEVEN LOCKS RD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
ROCKVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20854-2931
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-562-7200
Provider Business Practice Location Address Fax Number:
301-424-1565
Provider Enumeration Date:
12/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  D0065704 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: D0065704 . This is a "MEDICAL STATE LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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