Provider Demographics
NPI:1336452499
Name:HOWARD COUNTY ENT, LLC
Entity Type:Organization
Organization Name:HOWARD COUNTY ENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNGJOO
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-430-9747
Mailing Address - Street 1:6755 BUSINESS PKWY
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6340
Mailing Address - Country:US
Mailing Address - Phone:443-430-9747
Mailing Address - Fax:443-927-7374
Practice Address - Street 1:6755 BUSINESS PKWY
Practice Address - Street 2:SUITE 302
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6340
Practice Address - Country:US
Practice Address - Phone:443-430-9747
Practice Address - Fax:443-927-7374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-19
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD425368207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H73624Medicare UPIN