Provider Demographics
NPI:1215975974
Name:YUNE, MARC EAN (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:EAN
Last Name:YUNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 OLD ALABAMA ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-2258
Mailing Address - Country:US
Mailing Address - Phone:770-393-9000
Mailing Address - Fax:770-393-9006
Practice Address - Street 1:1825 OLD ALABAMA RD STE 201
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-2258
Practice Address - Country:US
Practice Address - Phone:770-393-9000
Practice Address - Fax:770-393-9006
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA041395174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA041395OtherMEDICAL LICENSE
04BDBZBMedicare ID - Type Unspecified
GA041395OtherMEDICAL LICENSE