Provider Demographics
NPI:1992794101
Name:YERG, JOHN E II (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:YERG
Suffix:II
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 1:5410 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 117
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2859
Mailing Address - Country:US
Mailing Address - Phone:202-966-8868
Mailing Address - Fax:202-244-3071
Practice Address - Street 1:5410 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 117
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2859
Practice Address - Country:US
Practice Address - Phone:202-966-8868
Practice Address - Fax:202-244-3071
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DC15876207RP1001X
MDD33554207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC00B545J09Medicare PIN
B95151Medicare UPIN