Healthcare Provider Details

I. General information

NPI: 1336645290
Provider Name (Legal Business Name): JOSEPH BAHNG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOEY BAHNG

II. Dates (important events)

Enumeration Date: 03/31/2018
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 PENNSYLVANIA AVE NW
WASHINGTON DC
20037-3201
US

IV. Provider business mailing address

319 S 3RD ST
DENTON MD
21629-1231
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-2500
  • Fax: 202-741-2550
Mailing address:
  • Phone: 407-383-9718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberC1-0029810
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD210002583
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD30662
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101289478
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: