Provider Demographics
NPI:1497789564
Name:YUNYONGYING, YUNYONG (MD)
Entity Type:Individual
Prefix:MR
First Name:YUNYONG
Middle Name:
Last Name:YUNYONGYING
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 1:716 MAIDEN CHOICE LN
Mailing Address - Street 2:SUITE LL2
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5943
Mailing Address - Country:US
Mailing Address - Phone:410-744-0060
Mailing Address - Fax:410-922-0782
Practice Address - Street 1:716 MAIDEN CHOICE LN
Practice Address - Street 2:SUITE LL2
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-5943
Practice Address - Country:US
Practice Address - Phone:410-744-0060
Practice Address - Fax:410-922-0782
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD16042208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
E98514Medicare UPIN
052SMedicare ID - Type Unspecified