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General NPI Number Information
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NPI Number | 1366443129
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Entity Type | Individual
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Provider Name | ALAN M YAHANDA MD
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Gender | Male
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 06/10/2024
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Provider Practice Location Address
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Address Line | 11050 PARKVIEW CIRCLE DR
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City | FORT WAYNE
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State | IN
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Zip | 46845-1739
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Country | US
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Telephone | 833-274-8326
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Fax | 260-266-7935
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Provider Business Mailing Address
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Address Line | 11109 PARKVIEW PLAZA DR # 117
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City | FORT WAYNE
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State | IN
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Zip | 46845-1701
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 071202
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | 2021000619
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 01053134A
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License Number State | IN
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