1811122898 NPI number — ALBERT S.C. SUN, M.D., P.A.

Table of content: (NPI 1811122898)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811122898 NPI number — ALBERT S.C. SUN, M.D., P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALBERT S.C. SUN, M.D., P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1811122898
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1716 HARFORD RD
Provider Second Line Business Mailing Address:
SUITE 105
Provider Business Mailing Address City Name:
FALLSTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21047-2643
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-877-1733
Provider Business Mailing Address Fax Number:
410-877-1733

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1716 HARFORD RD
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
FALLSTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21047-2643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-877-1733
Provider Business Practice Location Address Fax Number:
410-877-1733
Provider Enumeration Date:
05/20/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SUN
Authorized Official First Name:
ALBERT
Authorized Official Middle Name:
SHAN-CHING
Authorized Official Title or Position:
SOLE PROPIETOR
Authorized Official Telephone Number:
410-877-1733

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  D0018779 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RP1001X , with the licence number: D0018779 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0400703 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1158241 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 455516 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8401AS . This is a "CAREFIRST BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 843756 . This is a "MAMSI PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: T769 0001 . This is a "BLUE CHOICE CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2922 . This is a "COVENTRY HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 41527 . This is a "COVENTRY DIAMOND PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: T769 0001 . This is a "FEDERAL BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 029023 . This is a "JOHNS HOPKINS HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0400703 . This is a "UNITED HEALTHCARE FAMILY FIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 250751000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 088380000 . This is a "BLUE CROSS BLUE SHIELD PHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2796 . This is a "BRAVO HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9000437 . This is a "PRUDENTIAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 98453-01 . This is a "AMERIGROUP MARYLAND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 98453-02 . This is a "AMERIGROUP MARYLAND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 029023 . This is a "PRIORITY PARTNERS MCO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3725 . This is a "MEDSTAR FAMILLY CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 406291389 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".




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