Provider Demographics
NPI:1457511883
Name:YAVAROW, COLLEEN K (DO)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:K
Last Name:YAVAROW
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 LONG SANDS RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1158
Mailing Address - Country:US
Mailing Address - Phone:207-351-3777
Mailing Address - Fax:
Practice Address - Street 1:127 LONG SANDS RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1158
Practice Address - Country:US
Practice Address - Phone:207-351-3777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHLT4382207RX0202X
MEDO2579207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology