MEDICARE: PHILIP ALEXANDRE YEON 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	207RI0200X	Infectious Disease Physician	29436	SC
2	207R00000X	Internal Medicine Physician	29436	SC

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366418832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILIP ALEXANDRE YEON MD

Provider Business Mailing Address
First Line	:	PO BOX 402145
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-2145
Country	:	US
Telephone Number	:	803-296-7306
Fax Number	:	803-296-7330

Provider Business Practice Location Address
First Line	:	1333 TAYLOR ST
Second Line	:	SUITE 6F
City	:	COLUMBIA
State	:	SC
Zip	:	29201-2923
Country	:	US
Telephone Number	:	803-296-3273
Fax Number	:	803-296-7061

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

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	08/06/2013

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Directions to “ PHILIP ALEXANDRE YEON MD” Practice Location

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