Provider Demographics
NPI:1467572750
Name:SON, HYUN JOO (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:HYUN
Middle Name:JOO
Last Name:SON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6520 BALLYMORE LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1292
Mailing Address - Country:US
Mailing Address - Phone:410-531-8101
Mailing Address - Fax:
Practice Address - Street 1:6520 BALLYMORE LN
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1292
Practice Address - Country:US
Practice Address - Phone:410-531-8101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16745183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist