Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 73241 | WI |
NPI | 1043692627 |
---|---|
Provider Name | Dr. Samuel Seunghoon Yoon |
First Address | Milwaukee, WI 53215-2843 |
Second Address | Hartland, WI 53029-9385 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2015 |
Last Update Date | 24/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100101732 | (05) | WI |