Healthcare Provider Details

I. General information

NPI: 1851499784
Provider Name (Legal Business Name): RICHARD GEORGE YERON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 W PATRICK ST
FREDERICK MD
21703-3967
US

IV. Provider business mailing address

1090 W PATRICK ST
FREDERICK MD
21703-3967
US

V. Phone/Fax

Practice location:
  • Phone: 301-662-0757
  • Fax: 301-662-0725
Mailing address:
  • Phone: 301-662-0757
  • Fax: 301-662-0725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberD41717
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: