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NPI Code Detail

MEDICARE: MR. DEREK W YEE PA

MEDICARE: MR. DEREK W YEE PA
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
1363A00000XPhysician Assistant0110007626VA
2363AM0700XMedical Physician Assistant
3363A00000XPhysician AssistantPA200001920DC

General Provider Information

NPI Number : 1972963197
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DEREK W YEE PA
Provider Business Mailing Address
First Line : 6201 GREENLEIGH AVE FL 2
Second Line :
City : MIDDLE RIVER
State : MD
Zip : 21220-2004
Country : US
Telephone Number : 410-933-2704
Fax Number :
Provider Business Practice Location Address
First Line : 1900 ELECTRIC RD
Second Line :
City : SALEM
State : VA
Zip : 24153-7494
Country : US
Telephone Number : 540-776-4000
Fax Number : 540-776-4196
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2016
Last Update Date : 07/16/2024

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