Healthcare Provider Details

I. General information

NPI: 1710163332
Provider Name (Legal Business Name): MRS. ADRIANNE S OH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 PUBLIC LANDING RD
SNOW HILL MD
21863-2453
US

IV. Provider business mailing address

220 HITCHENS AVE UNIT 101
OCEAN CITY MD
21842-7561
US

V. Phone/Fax

Practice location:
  • Phone: 410-632-9915
  • Fax: 410-632-9902
Mailing address:
  • Phone: 336-406-5823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number19183
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: