Provider Demographics
NPI:1730201625
Name:YOON, MICHELLE JAEIM (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:JAEIM
Last Name:YOON
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 1:100 HIGHLAND ST STE 221
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-3876
Mailing Address - Country:US
Mailing Address - Phone:617-632-7500
Mailing Address - Fax:617-632-7522
Practice Address - Street 1:100 HIGHLAND ST STE 221
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-3876
Practice Address - Country:US
Practice Address - Phone:617-632-7500
Practice Address - Fax:617-632-7522
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15011207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology