Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 209741 | MA |
NPI | 1003808197 |
---|---|
Provider Name | David Hyungjun Yi |
First Address | Chelmsford, MA 01824-2712 |
Second Address | Chelmsford, MA 01824-2712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 29/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0138479 | (05) | MA |
H53153 | (02) |