Provider Demographics
NPI:1184027922
Name:HO, AUDREY CHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:CHAN
Last Name:HO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10409 SHEPHERDS CROOK CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1902
Mailing Address - Country:US
Mailing Address - Phone:610-725-0435
Mailing Address - Fax:
Practice Address - Street 1:10409 SHEPHERDS CROOK CT
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-1902
Practice Address - Country:US
Practice Address - Phone:610-725-0435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD071281L207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology