Healthcare Provider Details

I. General information

NPI: 1619610870
Provider Name (Legal Business Name): YUSUF YALCIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2930 CHESTERFIELD AVE
CHARLESTON WV
25304-1125
US

IV. Provider business mailing address

2930 CHESTERFIELD AVE
CHARLESTON WV
25304-1125
US

V. Phone/Fax

Practice location:
  • Phone: 304-351-1700
  • Fax:
Mailing address:
  • Phone: 304-351-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number293509
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number36723
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: