Provider Demographics
NPI:1164464285
Name:SOHN, SAMUEL MYUNGJIN (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:MYUNGJIN
Last Name:SOHN
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 1:60 N PECOS RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7333
Mailing Address - Country:US
Mailing Address - Phone:702-897-1330
Mailing Address - Fax:702-897-9499
Practice Address - Street 1:60 N PECOS RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7333
Practice Address - Country:US
Practice Address - Phone:702-897-1330
Practice Address - Fax:702-897-9499
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12434208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery