Healthcare Provider Details

I. General information

NPI: 1720092901
Provider Name (Legal Business Name): YOON PLASTIC SURGERY, MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9715 MEDICAL CENTER DR SUITE 233
ROCKVILLE MD
20850-3320
US

IV. Provider business mailing address

9715 MEDICAL CENTER DR SUITE 233
ROCKVILLE MD
20850-3320
US

V. Phone/Fax

Practice location:
  • Phone: 301-913-0304
  • Fax: 301-913-0306
Mailing address:
  • Phone: 301-913-0304
  • Fax: 301-913-0306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberD0063984
License Number StateMD

VIII. Authorized Official

Name: DR. SUNG WON YOON
Title or Position: DIRECTOR
Credential: MD
Phone: 301-913-0304