Healthcare Provider Details

I. General information

NPI: 1154394179
Provider Name (Legal Business Name): KING G YEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10590 N MERIDIAN ST
INDIANAPOLIS IN
46290-1028
US

IV. Provider business mailing address

10590 N MERIDIAN ST
CARMEL IN
46290-1028
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-6666
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number01029014A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: