Provider Demographics
NPI:1346534294
Name:YUNG, MICHAEL ORIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ORIN
Last Name:YUNG
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 1:10800 E GEDDES AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3895
Mailing Address - Country:US
Mailing Address - Phone:303-761-9190
Mailing Address - Fax:720-874-4462
Practice Address - Street 1:4021 AVENUE B
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4602
Practice Address - Country:US
Practice Address - Phone:303-761-9190
Practice Address - Fax:720-874-4462
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2024-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA416762085R0202X
CO575412085R0202X
KS04-395642085R0202X
HIMD189142085R0202X
NE277912085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO18588506Medicaid
NENA1215108Medicare PIN
CO559358YQ33Medicare PIN
NENA2517085Medicare PIN
CO559358ZLJ3Medicare PIN
KSKA3249085Medicare PIN
CO559358YQPGMedicare PIN
CO18588506Medicaid
CO559358YQN9Medicare PIN
KS111257094Medicare PIN