Provider Demographics
NPI:1134152416
Name:HSU, PAULINE (MD)
Entity type:Individual
Prefix:DR
First Name:PAULINE
Middle Name:
Last Name:HSU
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 1:9706 STARLING RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-1775
Mailing Address - Country:US
Mailing Address - Phone:410-418-5295
Mailing Address - Fax:
Practice Address - Street 1:110 BAUGHMANS LN
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4059
Practice Address - Country:US
Practice Address - Phone:304-846-0300
Practice Address - Fax:301-663-6048
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0053595208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
700274OtherNCPPO
9970OtherKAISER
0068OtherCAREFIRST DC
284418OtherMAMSI
011734OtherJOHNS HOPKINS HEALTHCARE
68592204OtherCAREFIRST MARYLAND
113574OtherCOVENTRY
1881242OtherUNITED HEALTHCARE
2550964OtherAETNA HMO
7816465002OtherCIGNA
MD53303Medicaid
5359733OtherAETNA PPO
0068OtherCAREFIRST DC
9970OtherKAISER
A369Medicare ID - Type UnspecifiedMEDICARE FREDERICK