Provider Demographics
NPI:1376582692
Name:YOLEN, STEVEN R (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:YOLEN
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 1:45 WELLS ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-2927
Mailing Address - Country:US
Mailing Address - Phone:401-596-6330
Mailing Address - Fax:401-348-0420
Practice Address - Street 1:45 WELLS ST
Practice Address - Street 2:SUITE 103
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-2927
Practice Address - Country:US
Practice Address - Phone:401-596-6330
Practice Address - Fax:401-348-0420
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD10338207RG0100X
CT026127207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT003108273Medicaid
RI9021219Medicaid
B82927Medicare UPIN
RI007009106Medicare ID - Type Unspecified
CT100000388Medicare ID - Type Unspecified