Provider Demographics
NPI:1992756571
Name:HARNE,SONG AND WOO, M.D.,P.A.
Entity type:Organization
Organization Name:HARNE,SONG AND WOO, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-879-4879
Mailing Address - Street 1:2007 ROCK SPRING RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21050-2620
Mailing Address - Country:US
Mailing Address - Phone:410-879-4879
Mailing Address - Fax:410-893-4763
Practice Address - Street 1:2007 ROCK SPRING RD
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-2620
Practice Address - Country:US
Practice Address - Phone:410-879-4879
Practice Address - Fax:410-893-4763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS301Medicare PIN