| C Yadmark Md Pllc | |
|
31610 Plymouth Rd Livonia MI 48150 | |
| (734) 421-2840 | |
| (734) 421-4045 |
| Full Name | C Yadmark Md Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 31610 Plymouth Rd, Livonia, Michigan |
| Authorized Official Name and Position | Chuck Yadmark (PRESIDENT) |
| Authorized Official Contact | 7348831334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| C Yadmark Md Pllc 31610 Plymouth Rd Livonia MI 48150-1932 Ph: (734) 421-2840 | C Yadmark Md Pllc 31610 Plymouth Rd Livonia MI 48150 Ph: (734) 421-2840 |
| NPI Number | 1639656184 |
|---|---|
| Provider Enumeration Date | 07/26/2018 |
| Last Update Date | 07/26/2018 |
| Medicare PECOS PAC ID | 0547510901 |
|---|---|
| Medicare Enrollment ID | O20180815003114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639656184 | NPI | - | NPPES |
| 4301063359 | Other | MI | STATE MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301063359 (Michigan) | Primary |
| Provider Name | Chuck Yadmark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891803029 PECOS PAC ID: 1456373398 Enrollment ID: I20051220000787 |
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