Basic Information
Provider Information
NPI: 1316913098
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SUN
FirstName: YUN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 645 N MAIN ST
Address2:  
City: HIGH POINT
State: NC
PostalCode: 272605017
CountryCode: US
TelephoneNumber: 3368830029
FaxNumber: 3368830867
Practice Location
Address1: 3402 BATTLEGROUND AVE
Address2:  
City: GREENSBORO
State: NC
PostalCode: 274102404
CountryCode: US
TelephoneNumber: 3368830029
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/23/2006
LastUpdateDate: 12/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X9500244NCN Allopathic & Osteopathic PhysiciansInternal Medicine 
208VP0000X9500244NCY Allopathic & Osteopathic PhysiciansPain MedicinePain Medicine

ID Information
IDTypeStateIssuerDescription
582918200101NCCIGNA HEALTHCARE NUMBEROTHER
593501401NCAETNA - NON HMO NUMBEROTHER
8100401NCBCBS NUMBEROTHER
4136301NCWELLPATH/COVENTRY NUMBEROTHER
11020788101NCRAILROAD MEDICARE NUMBEROTHER
29193401NCMAMSI NUMBEROTHER
898100405NC MEDICAID
040816901NCUNITED HEALTHCARE NUMBEROTHER
272369101NCAETNA - HMO NUMBEROTHER
988601NCPARTNERS MEDICARE CHOICEOTHER
9234701NCMEDCOST NUMBEROTHER


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