Provider Demographics
NPI:1154540516
Name:LI, YINGJUN (MD)
Entity type:Individual
Prefix:
First Name:YINGJUN
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10805 HICKORY RIDGE RD
Mailing Address - Street 2:STE 201
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044
Mailing Address - Country:US
Mailing Address - Phone:410-884-0191
Mailing Address - Fax:410-997-2607
Practice Address - Street 1:10805 HICKORY RIDGE RD
Practice Address - Street 2:STE 201
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044
Practice Address - Country:US
Practice Address - Phone:410-884-0191
Practice Address - Fax:410-997-2607
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2017-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN390200000X2084N0400X
MDD707432084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology