Provider Demographics
NPI:1730152380
Name:AHN, HYO SEUNG (MD)
Entity type:Individual
Prefix:DR
First Name:HYO
Middle Name:SEUNG
Last Name:AHN
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 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:
Practice Address - Street 1:21 CROSSROADS DR
Practice Address - Street 2:STE 100
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5441
Practice Address - Country:US
Practice Address - Phone:410-356-8186
Practice Address - Fax:410-356-4180
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00258392085N0700X, 2085R0202X
DCMD0447972085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKA80OtherB/C B/S
DC2849OtherB/C B/S
MD3172521900Medicaid
MDJ062OtherB/C B/S
DEDD4343Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MDCD4495Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MDJ062OtherB/C B/S
MD434L674SMedicare ID - Type UnspecifiedLOCALITY/JURIS. CODE 01
MDCN2566Medicare ID - Type UnspecifiedRAILROAD MEDICARE
MD435L713SMedicare ID - Type UnspecifiedLOCALITY/JURIS. CODE 02