Provider Demographics
NPI:1346022951
Name:JANG, YOUNG CHU
Entity Type:Individual
Prefix:
First Name:YOUNG
Middle Name:CHU
Last Name:JANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3745 ASHLEY WAY
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1429
Mailing Address - Country:US
Mailing Address - Phone:912-428-2929
Mailing Address - Fax:
Practice Address - Street 1:10400 STEVENSON RD STE 210
Practice Address - Street 2:
Practice Address - City:STEVENSON
Practice Address - State:MD
Practice Address - Zip Code:21153-0600
Practice Address - Country:US
Practice Address - Phone:667-285-9005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02652171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist