Provider Demographics
NPI:1417247982
Name:YAHYA, MADIAN TAHER (MD)
Entity type:Individual
Prefix:DR
First Name:MADIAN
Middle Name:TAHER
Last Name:YAHYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-6099
Practice Address - Country:US
Practice Address - Phone:570-271-7149
Practice Address - Fax:570-271-7165
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT208600000X
PAMD4622042086S0102X
CT56901208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care