Healthcare Provider Details

I. General information

NPI: 1033117833
Provider Name (Legal Business Name): THEODORE C YEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 12/14/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 NORTH AVE
BATTLE CREEK MI
49017-3258
US

IV. Provider business mailing address

710 NORTH AVE
BATTLE CREEK MI
49017-3258
US

V. Phone/Fax

Practice location:
  • Phone: 269-969-6251
  • Fax: 269-969-6283
Mailing address:
  • Phone: 269-969-6251
  • Fax: 269-969-6283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number4301066501
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: