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General NPI Number Information
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NPI Number | 1881986255
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Entity Type | Individual
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Provider Name | JIYOUNG RYU MD
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Gender | Female
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | 8601 SIX FORKS RD SUITE 400
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City | RALEIGH
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State | NC
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Zip | 27615-5276
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Country | US
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Telephone | 919-578-9118
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Fax | 919-578-9118
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Provider Business Mailing Address
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Address Line | 303 PERIMETER CTR N SUITE 300
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City | ATLANTA
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State | GA
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Zip | 30346-3402
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Country | US
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Telephone | 877-513-7274
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Fax | 888-508-2509
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 67981
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 2013-02202
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License Number State | NC
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