Doctor Name: | MR. YOUNG HOON BAE |
NPI Number: | 1619931680 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 0101236788 |
Business Practice Address: | 2580 Potters Road Virginia Beach, VA - 234544324 |
Business Phone Number: | 7574989391 |
Business Fax Number: | 7574987073 |
Mailing Address: | 2580 Potters Road, Dominion Psychiatric Associates, Pllc VIRGINIA BEACH |
State: | VA |
Postal Code: | 234544324 |
Phone Number: | 7574989391 |
Fax Number: | 7574987073 |
NPI Enumeration Date: | 04/14/2006 |
NPI Last Update Date: | 09/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 0101236788 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |