Provider Demographics
NPI:1093997686
Name:YELVERTON, CHRISTOPHER BRENT (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:BRENT
Last Name:YELVERTON
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 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-922-0553
Mailing Address - Fax:
Practice Address - Street 1:10 HAGEN DR STE 300
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2660
Practice Address - Country:US
Practice Address - Phone:585-922-9770
Practice Address - Fax:585-922-9733
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245688207NS0135X
PAMD451829207NS0135X
NY274988207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03406439Medicaid
NYFY4607240OtherDEA NY