Basic Information
| Provider Information | |||||||||
| NPI: | 1801216080 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SUN | ||||||||
| FirstName: | YAMIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 658 | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305030658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7702975700 | ||||||||
| FaxNumber: | 7707181877 | ||||||||
| Practice Location | |||||||||
| Address1: | 725 JESSE JEWELL PKWY SE | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305013834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7702975700 | ||||||||
| FaxNumber: | 7707181877 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2014 | ||||||||
| LastUpdateDate: | 01/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | BP10049485 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0000X | 85452 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 207RX0202X | 85452 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
No ID Information.