Provider Demographics
NPI:1104816131
Name:YU, MICHAEL K (MD)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:K
Last Name:YU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6680 POE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-2854
Mailing Address - Country:US
Mailing Address - Phone:937-280-8400
Mailing Address - Fax:937-280-8373
Practice Address - Street 1:2350 MIAMI VALLEY DR STE 500
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4780
Practice Address - Country:US
Practice Address - Phone:937-425-0003
Practice Address - Fax:937-245-6308
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2022-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-29272208800000X
OH35088520208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2734698Medicaid
KS100396950BMedicaid
KS102246Medicare PIN
OH2734698Medicaid
OHH39973Medicare UPIN
OHYU4196941Medicare PIN
OH4196942Medicare PIN