Provider Demographics
NPI:1457327504
Name:MAH, HANS SANGHOON (MD)
Entity Type:Individual
Prefix:
First Name:HANS
Middle Name:SANGHOON
Last Name:MAH
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-7840
Mailing Address - Fax:
Practice Address - Street 1:8110 HEALTHCARE LOOP
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215
Practice Address - Country:US
Practice Address - Phone:704-316-2312
Practice Address - Fax:704-316-2316
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200101086208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC800690OtherPARTNERS MEDIC ARE CHOICE
NC1312HOtherBCBS
NC562034548OtherGROUP TAX ID
NC1200934OtherUNITED HEALTHCARE
NC249727OtherMAMSI
NCB6721OtherMEDCOST
NC2803066OtherAETNA
NC891312HMedicaid