Myungwoo Nam, M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

234 E149Th Street
Suite 8-20
Bronx, NY 10451

Phone

(718) 579-4719

Fax

(718) 579-4836

NPI assigned

May 15, 2021

Reactivated

Nov 3, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1621036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1194399014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 E149TH STREET",
            "address_2": "SUITE 8-20",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10451",
            "telephone_number": "821-089-4791",
            "fax_number": "718-579-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 E149TH STREET",
            "address_2": "SUITE 8-20",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10451",
            "telephone_number": "718-579-4719",
            "fax_number": "718-579-4836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "MYUNGWOO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-15",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "deactivation_date": "2022-10-31",
        "reactivation_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elpitha Hope Nalpantidis Malone
• Eftichia Kouli Nalpantidis, OTR/L
• Shreya Nalubola, MD
• Hye in Nam, D.M.D.
• Hye Jin Nam, D.M.D
• Tracy Tushabe Namata, MD
• Vikhyath Namireddy, MD
• Aziz Namjouyan, MD
• Soraya Namvar, R.PH., MS
• Fatoumata Nanakasse

• Student in an Organized Health Care Education/Training Program in Bronx, NY
• Providers in Bronx, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.