Individual ProviderMisop HanUrologyAllopathic & Osteopathic PhysiciansPractice Address600 N Wolfe St, Baltimore, MD 21287-0005(410) 955-4494(410) 955-6100PECOS EnrollmentBased on the most recent information from CMS, provider Misop Han is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1346290426Provider TypeIndividualFull NameHan, MisopCredentialM.D.GenderMaleSole ProprietorNoEnumeration Date5/11/2006Last Updated2/7/2013Contact InformationPractice LocationPractice Address600 N Wolfe St, Baltimore, MD 21287-0005Phone(410) 955-4494FaxUnlisted FaxMailing LocationMailing AddressPO Box 64255, Baltimore, MD 21264-4255Phone(410) 955-6100FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode208800000XPrimaryDescriptionUrologyAllopathic & Osteopathic PhysiciansLicenseD58710MarylandProvider IdentifiersIDDescriptionIssuerID432130800DescriptionMedicaidIssuerUnlistedMaryland