Provider Demographics
NPI:1508897075
Name:YEH, ALEXANDER K (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:K
Last Name:YEH
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 1:3353 COTTMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-1603
Mailing Address - Country:US
Mailing Address - Phone:215-332-4410
Mailing Address - Fax:215-332-6255
Practice Address - Street 1:3353 COTTMAN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19149-1603
Practice Address - Country:US
Practice Address - Phone:215-332-4410
Practice Address - Fax:215-332-6255
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039388L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0959517Medicaid
PA042733VTOMedicare PIN
PAB34250Medicare UPIN