Healthcare Provider Details

I. General information

NPI: 1124683370
Provider Name (Legal Business Name): MARIA HAEJIN YOON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA LIM DO

II. Dates (important events)

Enumeration Date: 05/02/2019
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12520 PROSPERITY DR STE 150
SILVER SPRING MD
20904-1687
US

IV. Provider business mailing address

12520 PROSPERITY DR STE 150
SILVER SPRING MD
20904-1687
US

V. Phone/Fax

Practice location:
  • Phone: 301-989-0085
  • Fax:
Mailing address:
  • Phone: 301-989-0085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberH0095041
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: