Basic Information
Provider Information
NPI: 1093861221
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOEHN-SARIC
FirstName: EVANNE
MiddleName: LOH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 703 SKYWATER RD
Address2:  
City: GIBSON ISLAND
State: MD
PostalCode: 210560686
CountryCode: US
TelephoneNumber: 4104399671
FaxNumber: 4104399671
Practice Location
Address1: 2700 WASHINGTON AVE
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212273115
CountryCode: US
TelephoneNumber: 4103683984
FaxNumber: 4105360636
Other Information
ProviderEnumerationDate: 01/29/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0804XD0023871MDY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry

No ID Information.


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