Provider Demographics
NPI:1821448846
Name:YANG, SUNMI (MD)
Entity Type:Individual
Prefix:
First Name:SUNMI
Middle Name:
Last Name:YANG
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 1:250 PARADISE RD
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-2948
Mailing Address - Country:US
Mailing Address - Phone:781-596-2000
Mailing Address - Fax:781-595-7111
Practice Address - Street 1:250 PARADISE RD
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-2948
Practice Address - Country:US
Practice Address - Phone:781-596-2000
Practice Address - Fax:781-595-7111
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101266724207Q00000X
VA0116029483207Q00000X
MAT286698207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty