Provider Demographics
NPI:1265413504
Name:YOUNG, DAVID S (PA C)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:S
Last Name:YOUNG
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Gender:M
Credentials:PA C
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Mailing Address - Street 1:PO BOX 30790
Mailing Address - Street 2:MEDINA EMERGENCY ASSOCIATES LTD
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-0790
Mailing Address - Country:US
Mailing Address - Phone:330-654-1185
Mailing Address - Fax:330-654-9086
Practice Address - Street 1:1000 E WASHINGTON
Practice Address - Street 2:MEDINA GENERAL HOSPITAL EMERGENCY DEPT
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256
Practice Address - Country:US
Practice Address - Phone:330-654-1185
Practice Address - Fax:330-654-9086
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2008-06-12
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Provider Licenses
StateLicense IDTaxonomies
OH50002239207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHYOPA25451Medicare PIN