Individual
WON SAM YI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 N GRANDVIEW AVE, DUBUQUE, IA 52001-6388
(563) 556-3944
(563) 594-5256
Mailing address
168 E 10TH ST, DUBUQUE, IA 52001-5001
(563) 556-3944
(563) 594-5256
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
ME137717
FL
2085R0203X
Therapeutic Radiology Physician
Primary
240628
NY
208D00000X
General Practice Physician
ME137717
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027662801
UNIVERA
NY
01
—
000528637003
BLUE CROSS BLUE SHIELD WNY
NY
05
—
02777448
—
NY
01
—
3713862
INDEPENDENT HEALTH
NY
Enumeration date
07/26/2006
Last updated
08/15/2019
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