MEDICARE: AMRITA YEARWOOD 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	21847	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110195840	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	21847	OTHER	AL	MEDICAL LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770559734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMRITA YEARWOOD MD

Provider Business Mailing Address
First Line	:	100 EDWINA ST
Second Line	:
City	:	EVERGREEN
State	:	AL
Zip	:	36401-3319
Country	:	US
Telephone Number	:	251-578-0278
Fax Number	:	251-578-0290

Provider Business Practice Location Address
First Line	:	100 EDWINA ST
Second Line	:
City	:	EVERGREEN
State	:	AL
Zip	:	36401-3319
Country	:	US
Telephone Number	:	251-578-0278
Fax Number	:	251-578-0290

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

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	05/02/2013

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Directions to “ AMRITA YEARWOOD MD” Practice Location

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