Healthcare Provider Details

I. General information

NPI: 1033533229
Provider Name (Legal Business Name): DAVID YUN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 10/30/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

USAMEDDAC 2480 LLEWELLYN AVE.
FORT MEADE MD
20755
US

IV. Provider business mailing address

USAMEDDAC 2480 LLEWELLYN AVE
FORT MEADE MD
20755
US

V. Phone/Fax

Practice location:
  • Phone: 205-999-0129
  • Fax:
Mailing address:
  • Phone: 205-999-0129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0097843
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberD0097843
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: