Provider Demographics
NPI:1093706103
Name:YOO, SUNG-EUN (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNG-EUN
Middle Name:
Last Name:YOO
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 1:6750 TRYON RD STE 103
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7056
Mailing Address - Country:US
Mailing Address - Phone:919-378-2332
Mailing Address - Fax:919-378-2333
Practice Address - Street 1:6750 TRYON RD STE 103
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7056
Practice Address - Country:US
Practice Address - Phone:919-378-2332
Practice Address - Fax:919-378-2333
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200401606207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2473765Medicaid
NC5900506Medicaid
I05059Medicare UPIN
NC5900506Medicaid
NC2036595AMedicare ID - Type Unspecified