Provider Demographics
NPI:1891912085
Name:RO, CHANHEE (PT)
Entity type:Individual
Prefix:DR
First Name:CHANHEE
Middle Name:
Last Name:RO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6204 DISCOVER CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-6700
Mailing Address - Country:US
Mailing Address - Phone:410-730-6785
Mailing Address - Fax:
Practice Address - Street 1:130 ADMIRAL COCHRANE DR
Practice Address - Street 2:101
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7368
Practice Address - Country:US
Practice Address - Phone:410-266-1500
Practice Address - Fax:410-266-1369
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD202672251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407997300Medicaid
MD865M624FMedicare PIN