Individual
MR. SUNG RYAN SHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, DHSC
Contact information
Practice address
6858 OLD DOMINION DR STE 102, MC LEAN, VA 22101-3832
(703) 847-9800
Mailing address
3833 FARR OAK CIR, FAIRFAX, VA 22030-2438
(571) 235-2828
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003258
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0083533
—
OH
Enumeration date
03/02/2010
Last updated
03/12/2025
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