Healthcare Provider Details

I. General information

NPI: 1316178437
Provider Name (Legal Business Name): GRACE CUIHONG YANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CUIHONG YANG MD

II. Dates (important events)

Enumeration Date: 08/06/2009
Last Update Date: 12/29/2021
Certification Date: 12/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 SOLAREX COURT
FREDERICK MD
21703
US

IV. Provider business mailing address

610 SOLAREX COURT
FREDERICK MD
21703
US

V. Phone/Fax

Practice location:
  • Phone: 301-663-6162
  • Fax:
Mailing address:
  • Phone: 301-663-6162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number125057251
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD074035
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: