Provider Demographics
NPI:1083828248
Name:YAMBOR, MARI M (MD)
Entity Type:Individual
Prefix:DR
First Name:MARI
Middle Name:M
Last Name:YAMBOR
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 1:104 YUKON LANE
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514
Mailing Address - Country:US
Mailing Address - Phone:919-408-8177
Mailing Address - Fax:919-408-8277
Practice Address - Street 1:1709 LEGION ROAD
Practice Address - Street 2:SUITE # 106
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-2373
Practice Address - Country:US
Practice Address - Phone:919-929-3838
Practice Address - Fax:919-408-8277
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC395022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
2036724Medicare ID - Type Unspecified
A50614Medicare UPIN