Provider Demographics
NPI:1629006465
Name:YU, VINCENT C (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:C
Last Name:YU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:23550 PARK ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2592
Mailing Address - Country:US
Mailing Address - Phone:313-724-2273
Mailing Address - Fax:313-724-1156
Practice Address - Street 1:23550 PARK ST
Practice Address - Street 2:SUITE 200
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124
Practice Address - Country:US
Practice Address - Phone:313-724-2273
Practice Address - Fax:313-724-1156
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2018-07-12
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Provider Licenses
StateLicense IDTaxonomies
MI4301051184207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF25611Medicare UPIN
MI0N25210Medicare ID - Type Unspecified