1790834125 NPI number — DR. JULIE TU HOANG M.D.

Table of content: DR. JULIE TU HOANG M.D. (NPI 1790834125)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790834125 NPI number — DR. JULIE TU HOANG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOANG
Provider First Name:
JULIE
Provider Middle Name:
TU
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790834125
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3333 N CALVERT ST STE 655
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21218-6516
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-554-2715
Provider Business Mailing Address Fax Number:
443-444-4775

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3333 N CALVERT ST STE 400
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21218-6501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-554-2715
Provider Business Practice Location Address Fax Number:
410-554-2740
Provider Enumeration Date:
01/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2081P2900X , with the licence number:  D0065828 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2029398 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P00460573 . This is a "RR MEDICARE MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 412789700 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: W2660017 . This is a "BCBS REGIONAL MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 2019427 . This is a "HIGHMARK BCBS MD POS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com