Organization
WONSOCK SHIN MD LLC
Active
Organization
WONSOCK SHIN MD LLC
Active
Other names
C H OH MD, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WONSOCK SHIN M.D. (MEDICAL DIRECTOR)
(703) 865-8615
Entity
Organization
Contact information
Practice address
410 PINE ST SE, SUITE 200, VIENNA, VA 22180-4861
(703) 865-8615
(301) 777-7455
Mailing address
410 PINE ST SE, SUITE 200, VIENNA, VA 22180-4861
(703) 865-8615
(301) 777-7455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363200800
—
MD
01
—
891935
MAMSI ID
—
01
—
9795404002
CIGNA ID
—
01
—
LP49CH
BC/BS OF MD
MD
Enumeration date
09/22/2005
Last updated
11/14/2025
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