Provider Demographics
NPI:1649731043
Name:YOO, CHARLIE JUNG HWAN (DO, MSC)
Entity type:Individual
Prefix:
First Name:CHARLIE
Middle Name:JUNG HWAN
Last Name:YOO
Suffix:
Gender:M
Credentials:DO, MSC
Other - Prefix:
Other - First Name:JUNG
Other - Middle Name:HWAN
Other - Last Name:YOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1285 HEMBREE RD STE 200A
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4995
Mailing Address - Country:US
Mailing Address - Phone:770-475-2710
Mailing Address - Fax:770-475-0078
Practice Address - Street 1:1285 HEMBREE RD STE 200A
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4995
Practice Address - Country:US
Practice Address - Phone:770-475-2710
Practice Address - Fax:770-475-0078
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02007863A207X00000X
PAOT019136207X00000X
GA102998207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery