| Wonsock Shin Md Llc | |
|
925 Bishop Walsh Rd Cumberland MD 21502-1845 | |
| (301) 759-3800 | |
| (301) 777-7455 |
| Full Name | Wonsock Shin Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 925 Bishop Walsh Rd, Cumberland, Maryland |
| Authorized Official Name and Position | Wonsock Shin (PHYSICIAN) |
| Authorized Official Contact | 3017593800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wonsock Shin Md Llc 925 Bishop Walsh Rd Cumberland MD 21502-1845 Ph: (301) 759-3800 | Wonsock Shin Md Llc 925 Bishop Walsh Rd Cumberland MD 21502-1845 Ph: (301) 759-3800 |
| NPI Number | 1972599249 |
|---|---|
| Provider Enumeration Date | 09/22/2005 |
| Last Update Date | 02/04/2009 |
| Medicare PECOS PAC ID | 0648374454 |
|---|---|
| Medicare Enrollment ID | O20140430001082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972599249 | NPI | - | NPPES |
| 891935 | Other | MAMSI ID | |
| 363200800 | Medicaid | MD | |
| LP49CH | Other | MD | BC/BS OF MD |
| 9795404002 | Other | CIGNA ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Wonsock Shin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821098203 PECOS PAC ID: 3577611938 Enrollment ID: I20140430001263 |
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