Provider Demographics
NPI:1033437017
Name:AN, SANG WOOK (MD)
Entity Type:Individual
Prefix:
First Name:SANG
Middle Name:WOOK
Last Name:AN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7602 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4088
Mailing Address - Country:US
Mailing Address - Phone:410-663-8100
Mailing Address - Fax:410-663-8119
Practice Address - Street 1:7602 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-4088
Practice Address - Country:US
Practice Address - Phone:410-663-8100
Practice Address - Fax:410-663-8119
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0075745207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine