1669497905 NPI number — DR. WENDY J YANG M.D.

Table of content: DR. WENDY J YANG M.D. (NPI 1669497905)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669497905 NPI number — DR. WENDY J YANG M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YANG
Provider First Name:
WENDY
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669497905
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 HOUGHTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAGINAW
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48602-5303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-583-6812
Provider Business Mailing Address Fax Number:
989-583-6915

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 HOUGHTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAGINAW
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48602-5303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-583-6812
Provider Business Practice Location Address Fax Number:
989-583-6915
Provider Enumeration Date:
07/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  4301077688 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 381870664 . This is a "HEALTH CARE ALLIANCE POOL" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: P00178307 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0731096 . This is a "BCBSM" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 080G376200 . This is a "BCBSM" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 146521 . This is a "GREAT LAKES HEALTH PLAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 381870664 . This is a "PPOM" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 7780591 . This is a "AETNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 381870664 . This is a "COMMERCIAL" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 104700722 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 381870664 . This is a "PRIVATE HEALTHCARE SYSTEM" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 381870664068 . This is a "COMMUNITH CHOICE MICHIGAN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 381870664 . This is a "PRIORITY HEALTH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: WY077688 . This is a "LICENSE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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