Provider Demographics
NPI:1134156854
Name:HONG, JEFFREY J (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:J
Last Name:HONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7695 SWEET HOURS WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2477
Mailing Address - Country:US
Mailing Address - Phone:410-381-5411
Mailing Address - Fax:
Practice Address - Street 1:575 MAIN STREET
Practice Address - Street 2:SUITE 351
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4353
Practice Address - Country:US
Practice Address - Phone:301-498-5990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD33983207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD532991400Medicaid
MDE27313Medicare UPIN
DC001074D14Medicare PIN