Provider Demographics
NPI:1043232788
Name:YOON, YOUNG DUG (MD)
Entity Type:Individual
Prefix:
First Name:YOUNG
Middle Name:DUG
Last Name:YOON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5075
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-5075
Mailing Address - Country:US
Mailing Address - Phone:856-616-8100
Mailing Address - Fax:856-616-1919
Practice Address - Street 1:2100 WESTCOTT DR
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822
Practice Address - Country:US
Practice Address - Phone:888-988-3404
Practice Address - Fax:856-616-1919
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0693250207P00000X
NY205617207P00000X
NJMA69325207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8023701Medicaid
G47531Medicare UPIN
NJ037903Medicare ID - Type Unspecified