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General NPI Number Information
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NPI Number | 1609922343
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Entity Type | Individual
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Provider Name | BENNETT W YU M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 16761 SOUTHPARK CENTER FAMILY HEALTH & SURGICAL CENTER
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City | STRONGSVILLE
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State | OH
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Zip | 44136
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Country | US
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Telephone | 440-878-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 12018 DEER CREEK RUN
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City | PLYMOUTH
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State | MI
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Zip | 48170-2863
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Country | US
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Telephone | 734-812-0889
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 0101235693
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | ME117476
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | ME117476
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | D0039204
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License Number State | MD
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