Provider Demographics
NPI:1134326754
Name:HONG-ZOHLMAN, SUSIE NAM (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSIE
Middle Name:NAM
Last Name:HONG-ZOHLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SUSIE
Other - Middle Name:NAM
Other - Last Name:HONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4442
Mailing Address - Country:US
Mailing Address - Phone:410-328-5349
Mailing Address - Fax:410-328-4382
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-5349
Practice Address - Fax:410-328-4382
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA243455207RC0000X
NY235735207RC0000X
MDD74269207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS062-0466OtherCAREFIRST BC/BS
MD487109000Medicaid
MD487109000Medicaid
MD246401Y3WMedicare PIN
MDS062-0466OtherCAREFIRST BC/BS