Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 25MB09702400 | NJ |
N | 207QS0010X | Family Doctor - Sports Medicine | OS015615 | PA |
NPI | 1235380288 |
---|---|
Provider Name | Dug Su Yun |
First Address | Camden, NJ 08103-1088 |
Second Address | Glassboro, NJ 08028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2008 |
Last Update Date | 17/07/2019 |