Provider Demographics
NPI:1558325316
Name:HAN, WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:HAN
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 1:2401 W BELVEDERE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5216
Mailing Address - Country:US
Mailing Address - Phone:410-601-4811
Mailing Address - Fax:410-601-8648
Practice Address - Street 1:2700 QUARRY LAKE DR
Practice Address - Street 2:SUITE 220
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3742
Practice Address - Country:US
Practice Address - Phone:410-601-9200
Practice Address - Fax:410-601-8648
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060796208M00000X
MDD60796207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY91LU 64554102OtherCAREFIRST BCBS MD
MD699420201Medicaid
J466 0005OtherCAREFIRST BCBS DC
C6235 P00354617OtherRAILROAD MEDICARE
MD699420201Medicaid
C6235 P00354617OtherRAILROAD MEDICARE
KY91LU 64554102OtherCAREFIRST BCBS MD