Provider Demographics
NPI:1609804020
Name:HAN, HESUN (MD)
Entity type:Individual
Prefix:DR
First Name:HESUN
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:497 WINN WAY
Mailing Address - Street 2:SUITE A-210
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030
Mailing Address - Country:US
Mailing Address - Phone:404-294-7033
Mailing Address - Fax:404-296-4661
Practice Address - Street 1:595 HURRICANE SHOALS RD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046
Practice Address - Country:US
Practice Address - Phone:404-645-7150
Practice Address - Fax:770-339-4797
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2018-05-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA44929207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00809234AMedicaid
GA44929OtherLIC NUMBER
GAF44876Medicare UPIN
GA39BDB2FMedicare PIN