MEDICARE: DR. MARC DAVID YELLE MD PHD

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	207L00000X	Anesthesiology Physician	2015-00398	NC
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	2015-00398	NC

General Provider Information

NPI Number	:	1871889501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARC DAVID YELLE MD PHD

Provider Business Mailing Address
First Line	:	PO BOX 945395
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30394-5395
Country	:	US
Telephone Number	:	888-820-9533
Fax Number	:	919-873-9821

Provider Business Practice Location Address
First Line	:	3050 DURALEIGH RD STE 201
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27612-5451
Country	:	US
Telephone Number	:	984-215-6950
Fax Number	:

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

Provider Enumeration Date	:	06/21/2011
Last Update Date	:	10/07/2021

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