Provider Demographics
NPI:1487655015
Name:YOO, BO HYUN (MD)
Entity Type:Individual
Prefix:DR
First Name:BO
Middle Name:HYUN
Last Name:YOO
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 1:5319 HOAG DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1492
Mailing Address - Country:US
Mailing Address - Phone:440-930-6040
Mailing Address - Fax:440-930-6094
Practice Address - Street 1:5319 HOAG DR STE 100
Practice Address - Street 2:
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44035-1492
Practice Address - Country:US
Practice Address - Phone:440-930-6015
Practice Address - Fax:440-930-6094
Is Sole Proprietor?:No
Enumeration Date:2005-08-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077595Y207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2166169Medicaid
OH2166169Medicaid
OHG70763Medicare UPIN