Healthcare Provider Details

I. General information

NPI: 1932286499
Provider Name (Legal Business Name): SKYL PHYSICAL MEDICINE & RHEUMATOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 10/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17000 HUBBARD DR SUITE 800
DEARBORN MI
48126-4258
US

IV. Provider business mailing address

17000 HUBBARD DR SUITE 800
DEARBORN MI
48126-4258
US

V. Phone/Fax

Practice location:
  • Phone: 313-240-7595
  • Fax: 313-240-7599
Mailing address:
  • Phone: 313-240-7595
  • Fax: 313-240-7599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. INKWANG YOON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 313-240-7595