Provider Demographics
NPI:1053302596
Name:YOON, ELEANOR H (MD)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:H
Last Name:YOON
Suffix:
Gender:F
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 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:8501 ARLINGTON BLVD STE 300
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4625
Practice Address - Country:US
Practice Address - Phone:703-560-1611
Practice Address - Fax:703-573-0210
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235841207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
115857OtherANTHEM
533606OtherNCPPO
540894297OtherGW ONE HEALTH
34300009OtherBCBS OF DC
0703850OtherUNHC
379651OtherALLIANCE
3503396OtherAETNA HMO
379651OtherMDIPA OPTIMUM
5569742OtherAETNA
VA01-0097592Medicaid
540894297OtherPHCS
9068176003OtherCIGNA
9068176003OtherCIGNA