Provider Demographics
NPI:1346217312
Name:YODER, MARY CATHERINE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:CATHERINE
Last Name:YODER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CATHY
Other - Middle Name:
Other - Last Name:YODER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:747 E COUNTY LINE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1081
Mailing Address - Country:US
Mailing Address - Phone:317-789-9600
Mailing Address - Fax:317-789-0600
Practice Address - Street 1:747 E COUNTY LINE RD
Practice Address - Street 2:SUITE B
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1081
Practice Address - Country:US
Practice Address - Phone:317-789-9600
Practice Address - Fax:317-789-0600
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01043991A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN01043991AOtherSTATE MEDICAL LICENSE
IN01043991BOtherSTATE CSR
IN01043991BOtherSTATE CSR
BY5279535OtherDEA NUMBER
IN01043991AOtherSTATE MEDICAL LICENSE