Provider Demographics
NPI:1770646036
Name:HAHN, SUK KYUN (MD MAC)
Entity type:Individual
Prefix:MR
First Name:SUK KYUN
Middle Name:
Last Name:HAHN
Suffix:
Gender:M
Credentials:MD MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1300 YORK RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6016
Mailing Address - Country:US
Mailing Address - Phone:410-821-5610
Mailing Address - Fax:410-821-5809
Practice Address - Street 1:1300 YORK RD
Practice Address - Street 2:SUITE 310
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6016
Practice Address - Country:US
Practice Address - Phone:410-821-5610
Practice Address - Fax:410-821-5809
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00578171100000X
MDD0037449207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD070461000Medicaid
MD3063Medicare ID - Type Unspecified
MDE56401Medicare UPIN