MEDICARE: YOUN AND MANNAN LLC

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
1	208000000X	Pediatrics Physician	D56044	MD

Other Identifiers

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

General Provider Information

NPI Number	:	1275560732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUN AND MANNAN LLC

Provider Business Mailing Address
First Line	:	1410 CRAIN HIGHWAY NORTH
Second Line	:	UNIT 5A
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061
Country	:	US
Telephone Number	:	410-761-1424
Fax Number	:	410-761-0301

Provider Business Practice Location Address
First Line	:	1410 CRAIN HIGHWAY NORTH
Second Line	:	UNIT 5A
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061
Country	:	US
Telephone Number	:	410-761-1424
Fax Number	:	410-761-0301

Authorized Official
Title or Position	:	PARTNER
Name	:	YOUNG JOO YOUN
Credential	:	MD
Telephone Number	:	410-761-1424

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	01/31/2012

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Directions to “YOUN AND MANNAN LLC ” Practice Location

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