Provider Demographics
NPI:1922277425
Name:YOUN PLASTIC SURGERY PLLC
Entity Type:Organization
Organization Name:YOUN PLASTIC SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:S
Authorized Official - Last Name:YOUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-273-7700
Mailing Address - Street 1:755 W BIG BEAVER RD
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4900
Mailing Address - Country:US
Mailing Address - Phone:248-273-7700
Mailing Address - Fax:248-273-7701
Practice Address - Street 1:755 W BIG BEAVER RD
Practice Address - Street 2:SUITE 1200
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4900
Practice Address - Country:US
Practice Address - Phone:248-273-7700
Practice Address - Fax:248-273-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAY0718182086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIAY071818OtherLICENSE
MI7062581OtherAETNA
MI2406329172OtherBCBSM
50068602OtherHAP
MIAY071818OtherLICENSE