Provider Demographics
NPI:1437126455
Name:YOON, PYONGSOO D (MD)
Entity Type:Individual
Prefix:
First Name:PYONGSOO
Middle Name:D
Last Name:YOON
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 1:257 MCDOWELL ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2606
Mailing Address - Country:US
Mailing Address - Phone:828-258-1121
Mailing Address - Fax:828-252-6114
Practice Address - Street 1:257 MCDOWELL ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2606
Practice Address - Country:US
Practice Address - Phone:412-748-6484
Practice Address - Fax:412-748-7150
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35072815208G00000X
PAMD047295L208G00000X
NC2019-02286208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1437126455Medicaid
OH2064377Medicaid
PA001526368Medicaid