Organization
ANNANDALE MEDICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. INGRID INSOOK CHUNG M.D. (MD)
(703) 378-3508
Entity
Organization
Contact information
Practice address
4229 LAFAYETTE CENTER DRIVE, SUITE #1790, CHANTILLY, VA 20151-1267
(703) 378-3508
(703) 378-6414
Mailing address
PO BOX 9302, MC LEAN, VA 22102-0302
(703) 378-3508
(703) 378-6414
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101049525
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136631
PTAN
VA
01
—
3100539
ALLANCE PPO/MAMSI
VA
01
—
38080001
BCBS-CAREFIRST
VA
01
—
4528765
AETNA
VA
01
—
461868
AETNA
VA
01
—
463068
BCBS-ANTHEM
VA
Enumeration date
04/13/2007
Last updated
02/28/2012
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