Provider Demographics
NPI:1114309267
Name:DING, YI (DO)
Entity Type:Individual
Prefix:DR
First Name:YI
Middle Name:
Last Name:DING
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 1:490 SUN VALLEY DR STE 103
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5642
Mailing Address - Country:US
Mailing Address - Phone:678-490-2255
Mailing Address - Fax:
Practice Address - Street 1:490 SUN VALLEY DR STE 103
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5642
Practice Address - Country:US
Practice Address - Phone:678-490-2255
Practice Address - Fax:678-799-7593
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA89733208100000X, 2081P2900X
VA0102204647208100000X, 2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation