Provider Demographics
NPI:1710163332
Name:OH, ADRIANNE S
Entity Type:Individual
Prefix:MRS
First Name:ADRIANNE
Middle Name:S
Last Name:OH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 HITCHENS AVE
Mailing Address - Street 2:UNIT 101
Mailing Address - City:OCEAN CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21842-7561
Mailing Address - Country:US
Mailing Address - Phone:336-406-5823
Mailing Address - Fax:
Practice Address - Street 1:6040 PUBLIC LANDING RD
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:MD
Practice Address - Zip Code:21863-2453
Practice Address - Country:US
Practice Address - Phone:410-632-9915
Practice Address - Fax:410-632-9902
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD171M00000X
MD19183104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD705371101Medicaid
MD705371101Medicaid