Healthcare Provider Details
I. General information
NPI: 1538163142
Provider Name (Legal Business Name): FRANK YUN-PU YANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/10/2005
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
845 WILLIAM HILTON PKWY
HILTON HEAD SC
29928-3404
US
IV. Provider business mailing address
PO BOX 749306
ATLANTA GA
30374-9306
US
V. Phone/Fax
- Phone: 843-341-2416
- Fax: 843-341-2417
- Phone: 843-341-2416
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 33171 |
| License Number State | SC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | MD33171 |
| License Number State | SC |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 0000-28821 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: