Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | D68702 | MD |
Y | 207VX0201X | Gynecologic Oncologist | D68702 | MD |
NPI | 1508929506 |
---|---|
Provider Name | Hyung Suk Ryu |
First Address | Baltimore, MD 21202-2001 |
Second Address | Baltimore, MD 21202-2001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 22/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1047058 | PREFERRED ONE (01) | MN |
133077 | UCARE (01) | MN |
2443612 | ARAZ (01) | MN |
774T0RY | BCBS (01) | MN |