Provider Demographics
NPI:1710149950
Name:YU, NICHOLAS RIN (MD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:RIN
Last Name:YU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3855 PLEASANT HILL RD STE 470
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1417
Mailing Address - Country:US
Mailing Address - Phone:678-312-7280
Mailing Address - Fax:678-312-7298
Practice Address - Street 1:3855 PLEASANT HILL RD STE 470
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1417
Practice Address - Country:US
Practice Address - Phone:678-312-7280
Practice Address - Fax:678-312-7298
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266187208600000X
CAA136120208600000X
FLME123106208600000X
GA89561208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery