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General NPI Number Information
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NPI Number | 1487987210
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Entity Type | Organization
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Legal Business Name | DR. MICHEAL YANKOWITZ LLC
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Dates
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Enumeration Date | 09/11/2009
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Last Update Date | 09/11/2009
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Provider Practice Location Address
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Address Line | 1216 W MAIN ST
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City | FESTUS
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State | MO
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Zip | 63028-1654
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Country | US
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Telephone | 636-933-4100
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Fax | 636-937-3788
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Provider Business Mailing Address
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Address Line | PO BOX 68 1216 WEST MAIN ST
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City | FESTUS
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State | MO
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Zip | 63028-0068
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Country | US
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Telephone | 636-933-4100
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Fax | 636-937-3788
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL YANKOWITZ
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Credential | DPM
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Telephone | 636-933-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 000621
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License Number State | MO
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