Individual
MISOP HAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(410) 955-4494
Mailing address
PO BOX 64255, BALTIMORE, MD 21264-4255
(410) 955-6100
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
D58710
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432130800
—
MD
Enumeration date
05/11/2006
Last updated
02/07/2013
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