Provider Demographics
NPI:1871561662
Name:OH, MIN CHUL (MD)
Entity type:Individual
Prefix:DR
First Name:MIN
Middle Name:CHUL
Last Name:OH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MITCH
Other - Middle Name:C
Other - Last Name:OH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:305 HOSPITAL DR
Mailing Address - Street 2:TATE CANCER CENTER
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5805
Mailing Address - Country:US
Mailing Address - Phone:410-553-8100
Mailing Address - Fax:410-553-8133
Practice Address - Street 1:305 HOSPITAL DR
Practice Address - Street 2:TATE CANCER CENTER
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5805
Practice Address - Country:US
Practice Address - Phone:410-553-8100
Practice Address - Fax:410-553-8133
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0038698207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD558321700Medicaid
MDE31678Medicare UPIN
MD558321700Medicaid
MDM560869FMedicare PIN