Provider Demographics
NPI:1326038977
Name:YAREMCHUK, MICHAEL J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:YAREMCHUK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15 PARKMAN ST
Mailing Address - Street 2:MGH WACC SUITE 435
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-3117
Mailing Address - Country:US
Mailing Address - Phone:978-535-6043
Mailing Address - Fax:978-535-6047
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:MGH WACC SUITE 435
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:978-535-6043
Practice Address - Fax:978-535-6047
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2011-05-31
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Provider Licenses
StateLicense IDTaxonomies
MA41996208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ06963OtherBCBS MA
MA3029662Medicaid
MA041996OtherTUFTS HEALTH PLAN
MAJ06963OtherBCBS MA
A59231Medicare UPIN