Healthcare Provider Details
I. General information
NPI: 1972866630
Provider Name (Legal Business Name): LI HAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/18/2012
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11116 MEDICAL CAMPUS RD
HAGERSTOWN MD
21742
US
IV. Provider business mailing address
11116 MEDICAL CAMPUS RD
HAGERSTOWN MD
21742-6710
US
V. Phone/Fax
- Phone: 301-790-8000
- Fax:
- Phone: 301-790-8000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | D0079139 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | D0079139 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: