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NPI Code Detail

MEDICARE: DR. CRYSTAL P YELDELL MD

MEDICARE: DR. CRYSTAL P YELDELL 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
1207Q00000XFamily Medicine PhysicianD0050348MD

General Provider Information

NPI Number : 1366500985
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CRYSTAL P YELDELL MD
Provider Business Mailing Address
First Line : 2101 E JEFFERSON ST
Second Line : KAISER PERMANENTE MEDICARE ENROLLMENT
City : ROCKVILLE
State : MD
Zip : 20852-4908
Country : US
Telephone Number : 301-816-2424
Fax Number :
Provider Business Practice Location Address
First Line : 6201 ANNAPOLIS RD
Second Line :
City : LANDOVER HILLS
State : MD
Zip : 20784-1307
Country : US
Telephone Number : 301-276-3377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2006
Last Update Date : 11/12/2024

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