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Individual

PAUL YOUNGBOK OH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2544 COURT DR STE G, GASTONIA, NC 28054-3450
(704) 854-9990
(704) 854-9045
Mailing address
2544 COURT DR STE G, GASTONIA, NC 28054-3450
(704) 854-9990
(704) 854-9045

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
01054173A
IN
207RG0100X
Gastroenterology Physician
Primary
2010-00244
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000202136
ANTHEM PROVIDER NUMBER
IN
01
10825690
CAQH NUMBER
IN
01
159C4
BCBS
NC
05
1689633794
NC
05
200340710
IN
01
510421
PHCS PID NUMBER
IN
Enumeration date
03/20/2006
Last updated
07/21/2022
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