Provider Demographics
NPI:1497942296
Name:YAMEIKA SURGICAL GROUP, P.C.
Entity Type:Organization
Organization Name:YAMEIKA SURGICAL GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:YANCEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-420-5710
Mailing Address - Street 1:2147 OLD GREENBRIER RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-2635
Mailing Address - Country:US
Mailing Address - Phone:757-420-5710
Mailing Address - Fax:
Practice Address - Street 1:2147 OLD GREENBRIER RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-2635
Practice Address - Country:US
Practice Address - Phone:757-420-5710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101223145282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG64766Medicare UPIN
VA00W303Y01Medicare PIN