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General NPI Number Information
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NPI Number | 1760889042
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Entity Type | Organization
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Legal Business Name | GARY YASHINSKY MD, PLC
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Dates
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Enumeration Date | 12/02/2014
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Last Update Date | 12/02/2014
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Provider Practice Location Address
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Address Line | 30055 NORTHWESTERN HWY STE. 150
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3230
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Country | US
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Telephone | 248-865-4150
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Fax |
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Provider Business Mailing Address
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Address Line | 30055 NORTHWESTERN HWY STE. 150
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3230
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Country | US
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Telephone | 248-865-4150
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. DENISE GAYE HARTUNG
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Credential | CPC
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Telephone | 313-498-2470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301044190
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License Number State | MI
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