MEDICARE: DR. DALE PATRICK YU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35082624	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174506646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DALE PATRICK YU MD

Provider Business Mailing Address
First Line	:	5184 SANDY LN
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-2738
Country	:	US
Telephone Number	:	513-868-1786
Fax Number	:	513-868-1758

Provider Business Practice Location Address
First Line	:	5184 SANDY LN
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-2738
Country	:	US
Telephone Number	:	513-868-1786
Fax Number	:	513-868-1758

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	03/23/2008

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