MEDICARE: DAVID J YOUNG II

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	172A00000X	Driver	T62507169	VA

General Provider Information

NPI Number	:	1356902845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID J YOUNG II

Provider Business Mailing Address
First Line	:	3505 FESTIVAL PARK PLZ
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-4452
Country	:	US
Telephone Number	:	804-912-8601
Fax Number	:

Provider Business Practice Location Address
First Line	:	3505 FESTIVAL PARK PLZ
Second Line	:
City	:	CHESTER
State	:	VA
Zip	:	23831-4452
Country	:	US
Telephone Number	:	804-912-8601
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2019
Last Update Date	:	06/25/2019

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Directions to “ DAVID J YOUNG II ” Practice Location

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