MEDICARE: TIMOTHY GREGG YING D.O.

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	207P00000X	Emergency Medicine Physician	34.013655	OH
2	207P00000X	Emergency Medicine Physician	02004972A	IN
3	207P00000X	Emergency Medicine Physician	5101009300	MI
4	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	009300	MI
5	207P00000X	Emergency Medicine Physician	2020042510	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11292535	OTHER		CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	TY009300	OTHER	MI	BLUE SHIELD

General Provider Information

NPI Number	:	1740381292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY GREGG YING D.O.

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1777 AXTELL DR
Second Line	:	SUITE 107
City	:	TROY
State	:	MI
Zip	:	48084-4404
Country	:	US
Telephone Number	:	248-842-7625
Fax Number	:

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	08/08/2025

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Directions to “ TIMOTHY GREGG YING D.O.” Practice Location

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