Healthcare Provider Details

I. General information

NPI: 1104260439
Provider Name (Legal Business Name): HOI TIK HYDE YUEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2013
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 3RD ST
GREENSBORO NC
27405-6967
US

IV. Provider business mailing address

4750 WATERS AVE STE 400
SAVANNAH GA
31404-6270
US

V. Phone/Fax

Practice location:
  • Phone: 336-890-3277
  • Fax: 336-365-7546
Mailing address:
  • Phone: 912-350-5937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number87948
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number87948
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number2024-01378
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: