Provider Demographics
NPI:1164510525
Name:YI, DAVID HUSUNG (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:HUSUNG
Last Name:YI
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 1:1701 N GEORGE MASON DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3610
Mailing Address - Country:US
Mailing Address - Phone:703-558-5559
Mailing Address - Fax:703-558-5558
Practice Address - Street 1:1625 N GEORGE MASON DRIVE
Practice Address - Street 2:SUITE 425
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3686
Practice Address - Country:US
Practice Address - Phone:703-717-4400
Practice Address - Fax:703-717-4401
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237734207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1164510525Medicaid
022152I37Medicare PIN