1912967183 NPI number — DANIEL YODER MD

Table of content: DANIEL YODER MD (NPI 1912967183)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912967183 NPI number — DANIEL YODER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YODER
Provider First Name:
DANIEL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1912967183
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 MEDICAL PARK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHEVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28803-2493
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-258-1586
Provider Business Mailing Address Fax Number:
828-258-6161

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2311 ASHEVILLE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENDERSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28791-1500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-258-1586
Provider Business Practice Location Address Fax Number:
828-258-6161
Provider Enumeration Date:
03/23/2006

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: 207W00000X , with the licence number:  200300542 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 89134JC , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00061933 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 134JC . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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