Provider Demographics
NPI:1285892570
Name:YOUNGYEUN, AMY (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:YOUNGYEUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 EAST BROADWAY
Mailing Address - Street 2:BOONE HOSPITAL CENTER
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202
Mailing Address - Country:US
Mailing Address - Phone:573-815-6000
Mailing Address - Fax:573-815-8377
Practice Address - Street 1:1600 EAST BROADWAY
Practice Address - Street 2:BOONE HOSPITAL CENTER
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202
Practice Address - Country:US
Practice Address - Phone:573-815-6000
Practice Address - Fax:573-815-8377
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-8321207R00000X
MO2011023198208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine