Provider Demographics
NPI:1053498766
Name:YOUN, SUGKEE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUGKEE
Middle Name:
Last Name:YOUN
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 1:13880 BRADDOCK RD STE 107
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2460
Mailing Address - Country:US
Mailing Address - Phone:703-965-0180
Mailing Address - Fax:703-266-9003
Practice Address - Street 1:13880 BRADDOCK RD STE 107
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-2460
Practice Address - Country:US
Practice Address - Phone:703-965-0180
Practice Address - Fax:703-266-9003
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235830207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI48896Medicare UPIN