Provider Demographics
NPI:1033328539
Name:JU, YVETTE (DO)
Entity Type:Individual
Prefix:DR
First Name:YVETTE
Middle Name:
Last Name:JU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 ARCHIMEDES CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-1095
Mailing Address - Country:US
Mailing Address - Phone:410-486-8394
Mailing Address - Fax:
Practice Address - Street 1:6495 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3245
Practice Address - Country:US
Practice Address - Phone:240-994-4356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDHOO64991208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation