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1548226103

NPI Code Detail

MEDICARE: BYUNG MINN JINN MD

MEDICARE: BYUNG MINN JINN 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	2084P0800X	Psychiatry Physician	35034483J	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000216103	OTHER	OH	ANTHEM BLUE CROSS
2	352328	OTHER	OH	WELLCARE HEALTH PLAN
3	000000216103	OTHER	OH	UNICARE
4	740999	OTHER	OH	BUCKEYE HEALTH PLAN
5	T34483	OTHER	OH	SUMMACARE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	4007644	OTHER	OH	AETNA

General Provider Information

NPI Number	:	1548226103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BYUNG MINN JINN MD

Provider Business Mailing Address
First Line	:	12395 MCCRACKEN RD
Second Line	:	UNIT A-UP & D
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-2967
Country	:	US
Telephone Number	:	216-587-6727
Fax Number	:	216-587-8347

Provider Business Practice Location Address
First Line	:	12395 MCCRACKEN RD
Second Line	:	UNIT A-UP & D
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-2967
Country	:	US
Telephone Number	:	216-587-6727
Fax Number	:	216-587-8347

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

Provider Enumeration Date	:	04/24/2006
Last Update Date	:	04/28/2016

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1386940724 — MS. LISA M DUNN LISW
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1699031708 — ANNA POPOVA MSN, APRN, PMHNP-BC
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Directions to “ BYUNG MINN JINN MD” Practice Location

Language	Start Address	Practice Location

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