Provider Demographics
NPI:1720317829
Name:BANG, HEE SANG (M AC LAC)
Entity Type:Individual
Prefix:MR
First Name:HEE SANG
Middle Name:
Last Name:BANG
Suffix:
Gender:M
Credentials:M AC LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 NORMANDY WOODS DR
Mailing Address - Street 2:G
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-4267
Mailing Address - Country:US
Mailing Address - Phone:215-820-8901
Mailing Address - Fax:
Practice Address - Street 1:7750 MONTPELIER RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-6010
Practice Address - Country:US
Practice Address - Phone:800-735-2968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-18
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01728171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist