Healthcare Provider Details

I. General information

NPI: 1568523231
Provider Name (Legal Business Name): YUNGGYO SOHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6323 GEORGIA AVE NW SUITE 200
WASHINGTON DC
20011-1101
US

IV. Provider business mailing address

2015 HICKORY HILL LN
SILVER SPRING MD
20906-5808
US

V. Phone/Fax

Practice location:
  • Phone: 202-291-0126
  • Fax: 202-291-0370
Mailing address:
  • Phone: 301-871-1978
  • Fax: 202-291-2222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD25919
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: