Provider Demographics
NPI:1548226103
Name:JINN, BYUNG MINN (MD)
Entity Type:Individual
Prefix:
First Name:BYUNG
Middle Name:MINN
Last Name:JINN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BYUNG
Other - Middle Name:
Other - Last Name:MINN JINN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:12395 MCCRACKEN RD
Mailing Address - Street 2:UNIT A-UP & D
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2967
Mailing Address - Country:US
Mailing Address - Phone:216-587-6727
Mailing Address - Fax:216-587-8347
Practice Address - Street 1:12395 MCCRACKEN RD
Practice Address - Street 2:UNIT A-UP & D
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2967
Practice Address - Country:US
Practice Address - Phone:216-587-6727
Practice Address - Fax:216-587-8347
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35034483J2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000216103OtherANTHEM BLUE CROSS
OH352328OtherWELLCARE HEALTH PLAN
OH000000216103OtherUNICARE
OH740999OtherBUCKEYE HEALTH PLAN
OHT34483OtherSUMMACARE
OH0271101Medicaid
OH4007644OtherAETNA
OH352328OtherWELLCARE HEALTH PLAN
OHT34483OtherSUMMACARE
OH7106661Medicare PIN
OH0517765Medicare PIN