Healthcare Provider Details

I. General information

NPI: 1356398069
Provider Name (Legal Business Name): HENG KE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2887 CHESTERFIELD AVE
BALTIMORE MD
21213-1249
US

IV. Provider business mailing address

200 HUNTERS RIDGE RD
TIMONIUM MD
21093-4009
US

V. Phone/Fax

Practice location:
  • Phone: 410-483-3553
  • Fax: 410-488-3168
Mailing address:
  • Phone: 410-561-9945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0018896
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: