Provider Demographics
NPI:1477867109
Name:YOON, DAVID (PHARM D)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:YOON
Suffix:
Gender:M
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 1:22214 SOLOMON BLVD APT 236
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-5073
Mailing Address - Country:US
Mailing Address - Phone:901-361-3775
Mailing Address - Fax:
Practice Address - Street 1:22214 SOLOMON BLVD APT 236
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-5073
Practice Address - Country:US
Practice Address - Phone:901-361-3775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302034362183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist