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NPI Code Detail

MEDICARE: DEANA YOUNG MD

MEDICARE: DEANA YOUNG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician0101-232348VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053383752
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEANA YOUNG MD
Provider Business Mailing Address
First Line : 213 S JEFFERSON ST STE 1006
Second Line :
City : ROANOKE
State : VA
Zip : 24011-1713
Country : US
Telephone Number : 540-224-5715
Fax Number :
Provider Business Practice Location Address
First Line : 1935 W MAIN ST
Second Line :
City : SALEM
State : VA
Zip : 24153-3109
Country : US
Telephone Number : 540-387-0441
Fax Number : 540-389-7868
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2006
Last Update Date : 08/05/2022

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Directions to “ DEANA YOUNG MD” Practice Location

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