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NPI Code Detail

MEDICARE: SCOTT S YEN MD

MEDICARE: SCOTT S YEN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician036090452IL
2207R00000XInternal Medicine Physician01084841AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00145831OTHERILMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30001634609OTHERILGROUP BC BS

General Provider Information

NPI Number : 1821056581
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT S YEN MD
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2231 CAREW ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-4713
Country : US
Telephone Number : 260-373-7765
Fax Number : 260-373-7760
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2006
Last Update Date : 03/09/2023

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Directions to “ SCOTT S YEN MD” Practice Location

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