MEDICARE: DR. EDWARD BUMNO YOON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	MD20398	ME
2	207Q00000X	Family Medicine Physician	MD20398	ME

General Provider Information

NPI Number	:	1073539466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD BUMNO YOON MD

Provider Business Mailing Address
First Line	:	PO BOX 9746
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04104-5040
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	895 WASHINGTON AVE
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-2737
Country	:	US
Telephone Number	:	207-791-3888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	11/17/2023

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