Provider Demographics
NPI:1467455188
Name:YEAMANS, BRUCE E (MD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:E
Last Name:YEAMANS
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 1:431 W LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:MYERSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17067-2328
Mailing Address - Country:US
Mailing Address - Phone:717-866-5755
Mailing Address - Fax:717-866-7120
Practice Address - Street 1:431 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:MYERSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17067-2328
Practice Address - Country:US
Practice Address - Phone:717-866-5755
Practice Address - Fax:717-866-7120
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD019774E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB33574Medicare UPIN