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Individual

DONGMIN SHIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
13047 FAIR LAKES SHOPPING CTR, FAIRFAX, VA 22033-5179
(703) 449-8186
Mailing address
12562 SUMMIT MANOR DR APT 303, FAIRFAX, VA 22033-5729
(508) 736-8985

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202221277
VA
183500000X
Pharmacist
PH241468
MA

Other

Enumeration date
11/22/2023
Last updated
11/22/2023
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