Provider Demographics
NPI:1790946481
Name:OUNG, TWETHIDA (MD)
Entity Type:Individual
Prefix:DR
First Name:TWETHIDA
Middle Name:
Last Name:OUNG
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 1:303 NORTH CLYDE MORRIS BLVD.
Mailing Address - Street 2:HALIFAX HEALTH MEDICAL CENTER
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-2709
Mailing Address - Country:US
Mailing Address - Phone:386-226-4542
Mailing Address - Fax:386-239-2354
Practice Address - Street 1:303 NORTH CLYDE MORRIS BLVD.
Practice Address - Street 2:HALIFAX HEALTH MEDICAL CENTER
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2709
Practice Address - Country:US
Practice Address - Phone:386-226-4542
Practice Address - Fax:386-239-2354
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107936207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine