| Byong J. Ahn, M.d. | |
|
347 Midway Blvd Suite 110 Elyria OH 44035-9006 | |
| (440) 324-5555 | |
| (440) 324-5512 |
| Full Name | Byong J. Ahn, M.d. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 347 Midway Blvd, Elyria, Ohio |
| Authorized Official Name and Position | Byong Jik Ahn (OWNER) |
| Authorized Official Contact | 4403245555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Byong J. Ahn, M.d. 347 Midway Blvd Suite 110 Elyria OH 44035-9006 Ph: (440) 324-5555 | Byong J. Ahn, M.d. 347 Midway Blvd Suite 110 Elyria OH 44035-9006 Ph: (440) 324-5555 |
| NPI Number | 1497082986 |
|---|---|
| Provider Enumeration Date | 11/04/2009 |
| Last Update Date | 11/04/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497082986 | NPI | - | NPPES |
| 2632397 | Medicaid | OH | |
| 2273856 | Medicaid | OH | |
| 0464680 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | E0000911 (Ohio) | Secondary |
| 102L00000X | Psychoanalyst | 35040472 (Ohio) | Secondary |
| 1041C0700X | Social Worker - Clinical | I0004304 (Ohio) | Primary |
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