Healthcare Provider Details

I. General information

NPI: 1083726053
Provider Name (Legal Business Name): HORATIO YEUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 BOW STREET
ELKTON MD
21921
US

IV. Provider business mailing address

PO BOX 278
ELKTON MD
21922-0278
US

V. Phone/Fax

Practice location:
  • Phone: 410-392-4000
  • Fax:
Mailing address:
  • Phone: 410-392-0037
  • Fax: 410-392-6880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD0036970
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: