Provider Demographics
NPI:1346554847
Name:YOON, HYUNGSIK
Entity Type:Individual
Prefix:
First Name:HYUNGSIK
Middle Name:
Last Name:YOON
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 1:20030 CENTURY BLVD
Mailing Address - Street 2:STE # 203
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1111
Mailing Address - Country:US
Mailing Address - Phone:240-246-7786
Mailing Address - Fax:240-246-7815
Practice Address - Street 1:20030 CENTURY BLVD
Practice Address - Street 2:STE # 203
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1111
Practice Address - Country:US
Practice Address - Phone:240-246-7786
Practice Address - Fax:240-246-7815
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03547111N00000X
VA0104556592111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD773591OtherOPTUM
MDS829OtherCAREFIRST
MD9629632OtherAETNA