Provider Demographics
NPI:1487976882
Name:CONG, ZHONGXIAO TOM (MAC, LAC, MA,)
Entity type:Individual
Prefix:DR
First Name:ZHONGXIAO
Middle Name:TOM
Last Name:CONG
Suffix:
Gender:M
Credentials:MAC, LAC, MA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6708 WISCONSIN AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5300
Mailing Address - Country:US
Mailing Address - Phone:301-654-2307
Mailing Address - Fax:
Practice Address - Street 1:6708 WISCONSIN AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20815-5300
Practice Address - Country:US
Practice Address - Phone:301-654-2307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01668171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist