Healthcare Provider Details

I. General information

NPI: 1316119480
Provider Name (Legal Business Name): YUN MEI FUNG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2008
Last Update Date: 10/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 JESSE HILL JR DR SE
ATLANTA GA
30303-3031
US

IV. Provider business mailing address

75 PIEDMONT AVE NE STE 700
ATLANTA GA
30303-2544
US

V. Phone/Fax

Practice location:
  • Phone: 404-616-5800
  • Fax: 404-616-0787
Mailing address:
  • Phone: 404-756-1403
  • Fax: 404-756-5252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number060263
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: