MEDICARE: DR. YOUNG JCO YOUN 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
1	208000000X	Pediatrics Physician	D22113	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	:	1629008743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YOUNG JCO YOUN MD

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

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	02/22/2012

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Directions to “ DR. YOUNG JCO YOUN MD” Practice Location

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