Provider Demographics
NPI:1376534495
Name:YOUNG, ANNA G (MD)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:G
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:14705 W UPRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:CHARLEVOIX
Mailing Address - State:MI
Mailing Address - Zip Code:49720-1949
Mailing Address - Country:US
Mailing Address - Phone:231-547-8777
Mailing Address - Fax:231-547-8638
Practice Address - Street 1:14705 W UPRIGHT ST
Practice Address - Street 2:
Practice Address - City:CHARLEVOIX
Practice Address - State:MI
Practice Address - Zip Code:49720-1949
Practice Address - Country:US
Practice Address - Phone:231-547-8777
Practice Address - Fax:231-547-8638
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2020-12-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301059816207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI080071539OtherRAILROAD MEDICARE
MI2843314Medicaid
MI2843314Medicaid
MI080071539OtherRAILROAD MEDICARE