Provider Demographics
NPI:1821097015
Name:AHN, BYUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:BYUNG
Middle Name:
Last Name:AHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3501 SINCLAIR LANE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213
Mailing Address - Country:US
Mailing Address - Phone:410-558-4888
Mailing Address - Fax:410-510-1393
Practice Address - Street 1:3700 FLEET ST.
Practice Address - Street 2:SUITE 200
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4124
Practice Address - Country:US
Practice Address - Phone:410-558-4900
Practice Address - Fax:410-522-1475
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD165742084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q71479Medicare UPIN