Healthcare Provider Details

I. General information

NPI: 1730188475
Provider Name (Legal Business Name): JOSEF K. YEAGER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15245 SHADY GROVE RD STE 370
ROCKVILLE MD
20850-6237
US

IV. Provider business mailing address

15245 SHADY GROVE RD STE 370
ROCKVILLE MD
20850-6237
US

V. Phone/Fax

Practice location:
  • Phone: 240-246-7417
  • Fax: 240-477-4364
Mailing address:
  • Phone: 240-246-7417
  • Fax: 240-246-4364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberD0028453
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: