Provider Demographics
NPI:1790834125
Name:HOANG, JULIE TU (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:TU
Last Name:HOANG
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 1:3333 N CALVERT ST STE 655
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-6516
Mailing Address - Country:US
Mailing Address - Phone:410-554-2715
Mailing Address - Fax:443-444-4775
Practice Address - Street 1:3333 N CALVERT ST STE 400
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-6501
Practice Address - Country:US
Practice Address - Phone:410-554-2715
Practice Address - Fax:410-554-2740
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00658282081P2900X
PAMD4336602081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2029398OtherBLUE SHIELD
MDP00460573OtherRR MEDICARE MD
MD412789700Medicaid
MDW2660017OtherBCBS REGIONAL MD
MD2019427OtherHIGHMARK BCBS MD POS
MD2019427OtherHIGHMARK BCBS MD POS
PA2029398OtherBLUE SHIELD
PAHO2029398OtherFREEDOM BLUE PPA
PAP00670430OtherRR MEDICARE PA
MD2019427OtherHIGHMARK BCBS MD POS