Provider Demographics
NPI:1730188475
Name:YEAGER, JOSEF K (MD)
Entity type:Individual
Prefix:
First Name:JOSEF
Middle Name:K
Last Name:YEAGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15245 SHADY GROVE RD STE 370
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6237
Mailing Address - Country:US
Mailing Address - Phone:240-246-7417
Mailing Address - Fax:240-246-4364
Practice Address - Street 1:15245 SHADY GROVE RD STE 370
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6237
Practice Address - Country:US
Practice Address - Phone:240-246-7417
Practice Address - Fax:240-477-4364
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0028453207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD328111600Medicaid
F47971Medicare UPIN