Edward Seung-Won Baek, D.C.
Individual provider Active NPI Chiropractor · Centreville, VA
NPI 1831401561 · NPPES record last updated Jul 10, 2010
Key facts
- NPI
- 1831401561
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 0104556727 (VA)
- Practice address
- 6134 Redwood Square Center
Suite 101
Centreville, VA 20121-2642 - Phone
- (703) 543-6788
- Fax
- (703) 543-4778
- NPI assigned
- Jul 10, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0104556727 | VA | Yes |
Addresses
Primary practice location
6134 Redwood Square Center
Suite 101
Centreville, VA 20121-2642
Mailing address
6134 Redwood Square Center
Suite 101
Centreville, VA 20121-2642
Phone (703) 543-6788
Other providers in Centreville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.