Healthcare Provider Details

I. General information

NPI: 1407016249
Provider Name (Legal Business Name): SUE HONG ROUTSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUE HONG M.D.

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 06/11/2023
Certification Date: 06/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WOLFE ST
BALTIMORE MD
21287-0005
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-9441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036.137098
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number036.137098
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberD97690
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: