Provider Demographics
NPI:1548224462
Name:AHN, MAX (MD)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:
Last Name:AHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:361 LANKENAU MEDICAL OFFICE BUILDING EAST
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-649-6420
Mailing Address - Fax:610-649-4689
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:361 LANKENAU MEDICAL OFFICE BUILDING EAST
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-649-6420
Practice Address - Fax:610-649-4689
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD419421208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA056418Medicare ID - Type Unspecified
PAH03030Medicare UPIN