Provider Demographics
NPI:1043462153
Name:YONTER, SIMGE JALE (MD)
Entity Type:Individual
Prefix:
First Name:SIMGE
Middle Name:JALE
Last Name:YONTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5464 WOODED WAY STE 42
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-5722
Mailing Address - Country:US
Mailing Address - Phone:312-714-5606
Mailing Address - Fax:
Practice Address - Street 1:5464 WOODED WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-5722
Practice Address - Country:US
Practice Address - Phone:312-714-5606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101267403208100000X
MDD85126208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD85126OtherMARYLAND BOARD OF PHYSICIANS