Provider Demographics
NPI:1669814851
Name:YESHNIK AND ASSOCIATES MD PA
Entity Type:Organization
Organization Name:YESHNIK AND ASSOCIATES MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:YESHNIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-876-5400
Mailing Address - Street 1:511 JERMOR LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6151
Mailing Address - Country:US
Mailing Address - Phone:410-876-5400
Mailing Address - Fax:410-871-9917
Practice Address - Street 1:511 JERMOR LN
Practice Address - Street 2:SUITE 101
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6151
Practice Address - Country:US
Practice Address - Phone:410-876-5400
Practice Address - Fax:410-871-9917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0030191207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD549371400Medicaid
MD549371400Medicaid
MDC57609Medicare UPIN