Provider Demographics
NPI:1619958642
Name:YI, SU-MIN (MD)
Entity Type:Individual
Prefix:MS
First Name:SU-MIN
Middle Name:
Last Name:YI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:UNIVERSITY OF IOWA HOSPITALS & CLINICS
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1082
Mailing Address - Country:US
Mailing Address - Phone:319-356-2169
Mailing Address - Fax:319-356-4547
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:UNIVERSITY OF IOWA HOSPITALS & CLINICS
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1082
Practice Address - Country:US
Practice Address - Phone:319-356-2169
Practice Address - Fax:319-356-4547
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA33207207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA39403OtherWELLMARK BCBS
IA0469080Medicaid
IA0469080Medicaid
I34354Medicare UPIN