Provider Demographics
NPI:1477635811
Name:YEHYAWI, MELINDA SCHWARZ (PAC)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:SCHWARZ
Last Name:YEHYAWI
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:947 14TH AVE SE
Mailing Address - Street 2:COMMUNITY HEALTH FREE CLINIC
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401-2610
Mailing Address - Country:US
Mailing Address - Phone:319-363-0416
Mailing Address - Fax:319-363-5569
Practice Address - Street 1:947 14TH AVE SE
Practice Address - Street 2:COMMUNITY HEALTH FREE CLINIC
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401
Practice Address - Country:US
Practice Address - Phone:319-363-0416
Practice Address - Fax:319-363-5569
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001719363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI18585Medicare PIN