Provider Demographics
NPI:1114238540
Name:BYUN, DAVID (DO)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:BYUN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 AVENUE H
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:NV
Mailing Address - Zip Code:89301-2615
Mailing Address - Country:US
Mailing Address - Phone:775-289-3001
Mailing Address - Fax:
Practice Address - Street 1:1500 AVENUE H
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:NV
Practice Address - Zip Code:89301
Practice Address - Country:US
Practice Address - Phone:775-289-3612
Practice Address - Fax:775-289-6423
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ006345208M00000X
NVDO1835208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist