Provider Demographics
NPI:1528013117
Name:YUH, JENNAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNAN
Middle Name:
Last Name:YUH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3972 LOOMIS PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-1800
Mailing Address - Country:US
Mailing Address - Phone:330-296-8239
Mailing Address - Fax:330-296-6528
Practice Address - Street 1:3972 LOOMIS PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-1800
Practice Address - Country:US
Practice Address - Phone:330-296-8239
Practice Address - Fax:330-296-6528
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35045904Y208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0510030Medicaid
A80639Medicare UPIN
OH0510030Medicaid