Individual
BETHEL SUNG MI TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4001
Mailing address
9622 OAKINGTON DR, FAIRFAX STATION, VA 22039-2641
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001285330
VA
Other
Enumeration date
04/30/2026
Last updated
04/30/2026
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