Provider Demographics
NPI:1144818782
Name:HYUN, BRANDON
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:HYUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS BLUE RIDGE LCC-19
Mailing Address - Street 2:UNIT 100102, BOX MEDICAL
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96628-3300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USS BLUE RIDGE LCC-19
Practice Address - Street 2:UNIT 100102, BOX MEDICAL
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96628-3300
Practice Address - Country:US
Practice Address - Phone:503-820-8533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102208916207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine