Basic Information
Provider Information
NPI: 1760578918
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOON
FirstName: ALEXANDER
MiddleName: H
NamePrefix: DR.
NameSuffix: JR.
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2931 E BIDDLE ST
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212133939
CountryCode: US
TelephoneNumber: 4439231886
FaxNumber: 4439239145
Practice Location
Address1: 707 N BROADWAY
Address2: TOWER-100
City: BALTIMORE
State: MD
PostalCode: 212051832
CountryCode: US
TelephoneNumber: 4439239141
FaxNumber: 4439239145
Other Information
ProviderEnumerationDate: 10/05/2006
LastUpdateDate: 03/04/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000XD36230MDN Other Service ProvidersSpecialist 
208000000XD36230MDY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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