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NPI Code Detail

MEDICARE: EVAN K YOO D.P.M.

MEDICARE: EVAN K YOO D.P.M.
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
1213ES0103XFoot & Ankle Surgery Podiatrist01642MD
2213E00000XPodiatrist01642MD

General Provider Information

NPI Number : 1912388661
Entity Type Code : Individual
Provider Name (Legal Business Name) : EVAN K YOO D.P.M.
Provider Business Mailing Address
First Line : 1 N MAIN ST
Second Line :
City : BEL AIR
State : MD
Zip : 21014-3592
Country : US
Telephone Number : 410-879-1212
Fax Number : 410-803-1859
Provider Business Practice Location Address
First Line : 5500 KNOLL NORTH DR STE 440
Second Line :
City : COLUMBIA
State : MD
Zip : 21045-2364
Country : US
Telephone Number : 410-730-0970
Fax Number : 410-730-0161
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2015
Last Update Date : 01/24/2023

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