Physician Compare National (NPI:1841463049)

HEALTHCARE PROVIDER: YOU SUN NAM MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1841463049
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3274722731
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110113001147
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	NAM
	Individual professional last name
Provider First Name	YOU SUN
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PULTE MEDICAL COLLEGE - NLG
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	THE LONGSTREET CLINIC, PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	2668465733
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	113
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	4224 FAIRBANKS DR
	Group Practice or individual's line 1 address
City	OAKWOOD
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	305662811
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7705336500
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110029
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTHEAST GEORGIA MEDICAL CENTER, INC
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y