Provider Demographics
NPI:1477236404
Name:OH, TIMOTHY JOON-KYUNG
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:JOON-KYUNG
Last Name:OH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 FRANKLIN SQUARE DR BLDG STE 205
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3936
Mailing Address - Country:US
Mailing Address - Phone:667-304-5434
Mailing Address - Fax:
Practice Address - Street 1:9101 FRANKLIN SQUARE DR BLDG STE 205
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3936
Practice Address - Country:US
Practice Address - Phone:667-304-5434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30231225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist