Healthcare Provider Details

I. General information

NPI: 1083831606
Provider Name (Legal Business Name): JOHN E YERG II MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5410 CONNECTICUT AVE NW STE 117
WASHINGTON DC
20015-2859
US

IV. Provider business mailing address

5410 CONNECTICUT AVE NW STE 117
WASHINGTON DC
20015-2859
US

V. Phone/Fax

Practice location:
  • Phone: 202-966-8868
  • Fax: 202-244-3071
Mailing address:
  • Phone: 202-966-8868
  • Fax: 202-244-3071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number15876
License Number StateDC

VIII. Authorized Official

Name: DR. JOHN E YERG II
Title or Position: PRESIDENT
Credential: MD
Phone: 202-966-8868