Individual
DR. MICHAEL SEUNGJUN BAEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 OPITZ BLVD STE G-209, WOODBRIDGE, VA 22191-3311
(703) 523-0611
(703) 670-2089
Mailing address
2300 OPITZ BLVD STE G-209, WOODBRIDGE, VA 22191-3311
(703) 523-0611
(703) 670-2089
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101260492
VA
208M00000X
Hospitalist Physician
0101260492
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116026404
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207Q00000X
FAMILY MEDICINE
VA
Enumeration date
06/28/2013
Last updated
01/27/2023
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