Provider Demographics
NPI:1689625691
Name:HUNG, PO-HSIU (MD)
Entity Type:Individual
Prefix:DR
First Name:PO-HSIU
Middle Name:
Last Name:HUNG
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 1:1916 CRAIN HWY SW
Mailing Address - Street 2:SUITE 8
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5563
Mailing Address - Country:US
Mailing Address - Phone:410-787-1600
Mailing Address - Fax:
Practice Address - Street 1:1916 CRAIN HWY SW
Practice Address - Street 2:SUITE 8
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5563
Practice Address - Country:US
Practice Address - Phone:410-787-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-14
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0025000207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD798661101Medicaid
MD798661100Medicaid
MD4425PHMedicare ID - Type Unspecified
MD798661101Medicaid
MD039168Medicare ID - Type Unspecified