Provider Demographics
NPI:1659671501
Name:SANG C. DOH, M.D.,P.A.
Entity Type:Organization
Organization Name:SANG C. DOH, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANG
Authorized Official - Middle Name:C
Authorized Official - Last Name:DOH
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:410-760-6623
Mailing Address - Street 1:1600 CRAIN HWY S
Mailing Address - Street 2:SUITE 206
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5577
Mailing Address - Country:US
Mailing Address - Phone:410-760-6623
Mailing Address - Fax:410-760-6624
Practice Address - Street 1:1600 CRAIN HWY S
Practice Address - Street 2:SUITE 206
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5577
Practice Address - Country:US
Practice Address - Phone:410-760-6623
Practice Address - Fax:410-760-6624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD19512174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD252331100Medicaid
MD252331100Medicaid
2842Medicare PIN