Provider Demographics
NPI:1588613095
Name:YOO, DOE-HYUN ROBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:DOE-HYUN
Middle Name:ROBERT
Last Name:YOO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1004
Mailing Address - Country:US
Mailing Address - Phone:336-832-7000
Mailing Address - Fax:
Practice Address - Street 1:3803 ROBERT PORCHER WAY
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2191
Practice Address - Country:US
Practice Address - Phone:336-286-3442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200500567207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901456Medicaid
NC182168OtherMEDCOST
NC3970850OtherAETNA
NC140GJOtherBCBS NC
NC806681OtherPARTNERS MEDICARE
NC2402666Medicare ID - Type UnspecifiedMEDICARE
NC806681OtherPARTNERS MEDICARE