Provider Demographics
NPI:1437128261
Name:HWANG, YINNAN (MD)
Entity Type:Individual
Prefix:MR
First Name:YINNAN
Middle Name:
Last Name:HWANG
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:P.O. BOX 425
Mailing Address - Street 2:1303 WATER PLANT RD.
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-0425
Mailing Address - Country:US
Mailing Address - Phone:919-269-4101
Mailing Address - Fax:919-269-8811
Practice Address - Street 1:1303 WATER PLANT RD.
Practice Address - Street 2:
Practice Address - City:ZEBULON
Practice Address - State:NC
Practice Address - Zip Code:27597-0425
Practice Address - Country:US
Practice Address - Phone:919-269-4101
Practice Address - Fax:919-269-8811
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28653208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890221JMedicaid
NC8945179Medicaid
203505FMedicare PIN
D33057Medicare UPIN
203505Medicare ID - Type Unspecified