MEDICARE: DR. YVONNE MEDRANO LAYUGAN M.D.

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
1	207Q00000X	Family Medicine Physician	2007021711	MO
2	207Q00000X	Family Medicine Physician	14160	HI

General Provider Information

NPI Number	:	1902940869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YVONNE MEDRANO LAYUGAN M.D.

Provider Business Mailing Address
First Line	:	2900 LEMAY FERRY ROAD, SUITE 200
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63125-3969
Country	:	US
Telephone Number	:	314-416-1926
Fax Number	:	314-416-1007

Provider Business Practice Location Address
First Line	:	2900 LEMAY FERRY ROAD, SUITE 200
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63125-3969
Country	:	US
Telephone Number	:	314-416-1926
Fax Number	:	314-416-1007

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	04/26/2011

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