MEDICARE: DR. CARL RAMSES YACOUB M.D.

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	2084N0400X	Neurology Physician	C1-0004626	DE

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	:	1386651099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARL RAMSES YACOUB M.D.

Provider Business Mailing Address
First Line	:	1423 CAPITOL TRL STE 1114
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19711-5709
Country	:	US
Telephone Number	:	302-996-9010
Fax Number	:	302-996-9027

Provider Business Practice Location Address
First Line	:	1423 CAPITOL TRL STE 1114
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19711-5709
Country	:	US
Telephone Number	:	302-996-9010
Fax Number	:	302-996-9027

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	09/05/2023

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