Provider Demographics
NPI:1659306868
Name:Y HOWARD PUNG MD PA
Entity Type:Organization
Organization Name:Y HOWARD PUNG MD PA
Other - Org Name:YUNG-HAO HOWARD PUNG MD PA
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:Y
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:PUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:301-770-7756
Mailing Address - Street 1:11119 ROCKVILLE PIKE
Mailing Address - Street 2:SUITE 406
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:301-770-7756
Mailing Address - Fax:301-770-5870
Practice Address - Street 1:11119 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 406
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852
Practice Address - Country:US
Practice Address - Phone:301-770-7756
Practice Address - Fax:301-770-5870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0042449207K00000X
DCMD19740207K00000X
VA0101046081207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F50929Medicare UPIN
MD00B534Y98Medicare ID - Type Unspecified