Provider Demographics
NPI:1568647857
Name:YANAGI, HIDETAKA (MD)
Entity Type:Individual
Prefix:DR
First Name:HIDETAKA
Middle Name:
Last Name:YANAGI
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 1:2324 MURPHY LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-3594
Mailing Address - Country:US
Mailing Address - Phone:336-760-6328
Mailing Address - Fax:336-760-6328
Practice Address - Street 1:SECTION ON INFECTIOUS DISEASE WAKE FOREST UNIV SM
Practice Address - Street 2:1 MEDICAL CENTER BOULEVARD
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-4584
Practice Address - Fax:336-716-3825
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC129906282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access