Provider Demographics
NPI:1275935348
Name:SUNWOOKIM, YONG
Entity Type:Individual
Prefix:MRS
First Name:YONG
Middle Name:
Last Name:SUNWOOKIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 MILL POOL CT
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-2450
Mailing Address - Country:US
Mailing Address - Phone:443-600-5551
Mailing Address - Fax:
Practice Address - Street 1:6 MILL POOL CT
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-2450
Practice Address - Country:US
Practice Address - Phone:443-600-5551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-20
Last Update Date:2014-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02172171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU02172OtherMARYLAND BOARD OF ACUPUNCTURE