Provider Demographics
NPI:1790075075
Name:TSENG, EVA (MD)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:TSENG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 E MONUMENT ST
Mailing Address - Street 2:ROOM 2-617
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0007
Mailing Address - Country:US
Mailing Address - Phone:410-614-1135
Mailing Address - Fax:
Practice Address - Street 1:2024 E MONUMENT ST
Practice Address - Street 2:ROOM 2-617
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0007
Practice Address - Country:US
Practice Address - Phone:410-614-1135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD0077139207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program