Healthcare Provider Details

I. General information

NPI: 1639116205
Provider Name (Legal Business Name): TONG-YI YAO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 06/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 CATON AVE
BALTIMORE MD
21229-5201
US

IV. Provider business mailing address

2008 THISTLEWOOD RD
BALTIMORE MD
21209-3768
US

V. Phone/Fax

Practice location:
  • Phone: 410-368-2011
  • Fax:
Mailing address:
  • Phone: 410-486-8498
  • Fax: 410-486-8498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD57578
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: