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General NPI Number Information
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NPI Number | 1699875682
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Entity Type | Organization
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Legal Business Name | DIGESTIVE & LIVER CLINIC, P.C.
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 11/27/2012
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Provider Practice Location Address
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Address Line | 11805 HARVARD LN
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City | CARMEL
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State | IN
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Zip | 46032-4663
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Country | US
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Telephone | 317-650-7454
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Fax | 800-314-7614
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Provider Business Mailing Address
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Address Line | 11805 HARVARD LN
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City | CARMEL
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State | IN
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Zip | 46032-4663
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Country | US
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Telephone | 317-650-7454
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Fax | 800-314-7614
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Authorized Official
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Title or Position | PRESIDENT
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Name | HWAN YOUNG YOO
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Credential | MD, PHD
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Telephone | 317-650-7454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 01047833A
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License Number State | IN
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