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General NPI Number Information
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NPI Number | 1134183403
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Entity Type | Organization
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Legal Business Name | EMAD YOUNAN MD PC
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 25 CENTENNIAL DR
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City | PEABODY
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State | MA
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Zip | 01960-7901
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Country | US
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Telephone | 978-532-2652
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2190
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City | WEST PEABODY
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State | MA
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Zip | 01960-7190
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Country | US
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Telephone | 781-231-7026
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EMAD S YOUNAN
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Credential | M.D.
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Telephone | 978-532-2657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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