Provider Demographics
NPI:1346387529
Name:YOON, DANIEL WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:WILLIAM
Last Name:YOON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4339 PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55409-1921
Mailing Address - Country:US
Mailing Address - Phone:402-968-2669
Mailing Address - Fax:
Practice Address - Street 1:6341 UNIVERSITY AVE NE
Practice Address - Street 2:FAIRVIEW FRIDLEY CLINIC
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-4343
Practice Address - Country:US
Practice Address - Phone:763-572-5710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN49893207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE4711OtherTEMPORARY MEDICAL LICENSE
MN49893OtherSTATE OF MINNESOTA MEDICAL LICENSE