MEDICARE: DAVID D YUAN 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	207RN0300X	Nephrology Physician	2012039495	MO

General Provider Information

NPI Number	:	1972552123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID D YUAN MD

Provider Business Mailing Address
First Line	:	PO BOX 411544
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-3544
Country	:	US
Telephone Number	:	314-763-0589
Fax Number	:	314-405-9368

Provider Business Practice Location Address
First Line	:	3394 MCKELVEY RD STE 115
Second Line	:
City	:	BRIDGETON
State	:	MO
Zip	:	63044-2531
Country	:	US
Telephone Number	:	314-763-0589
Fax Number	:	314-405-9368

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

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	10/16/2023

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Directions to “ DAVID D YUAN MD” Practice Location

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