Provider Demographics
NPI:1780147439
Name:BYUN, ERIC YOONJUN (PT, DPT)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:YOONJUN
Last Name:BYUN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 WESLEYAN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-3103
Mailing Address - Country:US
Mailing Address - Phone:800-603-6046
Mailing Address - Fax:866-231-7038
Practice Address - Street 1:1502 S MAIN ST STE 303
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21771-5375
Practice Address - Country:US
Practice Address - Phone:301-829-5880
Practice Address - Fax:301-829-5889
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27394225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist