Provider Demographics
NPI:1043256282
Name:YADAV, YOGINDER K (MD)
Entity Type:Individual
Prefix:DR
First Name:YOGINDER
Middle Name:K
Last Name:YADAV
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 1:122 12TH ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-2312
Mailing Address - Country:US
Mailing Address - Phone:304-487-7726
Mailing Address - Fax:304-431-5263
Practice Address - Street 1:122 12TH ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2312
Practice Address - Country:US
Practice Address - Phone:304-487-7726
Practice Address - Fax:304-431-5263
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20702207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1806714000Medicaid
WV001714001OtherBCBS
VA10314704Medicaid
WVP00290279OtherRAILROAD MEDICARE
VA010260817Medicaid
WVP00290279OtherMEDICARE RAILROAD
WVP00326455OtherRAILROAD MEDICARE
WV001714001OtherBLUE SHIELD
WV53141OtherUNICARE
WVP00290279OtherMEDICARE RAILROAD
WVYA4065012Medicare PIN