Provider Demographics
NPI:1306043716
Name:YU, JIN SUN (MD)
Entity Type:Individual
Prefix:
First Name:JIN
Middle Name:SUN
Last Name:YU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2320 N LAKE DR
Mailing Address - Street 2:SUITE 3603
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-4507
Mailing Address - Country:US
Mailing Address - Phone:414-270-4932
Mailing Address - Fax:414-291-5195
Practice Address - Street 1:2320 N LAKE DR
Practice Address - Street 2:SUITE 3603
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-4507
Practice Address - Country:US
Practice Address - Phone:414-270-4932
Practice Address - Fax:414-291-5195
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2010-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA107015207R00000X
WI54857-020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine