Provider Demographics
NPI:1689697880
Name:YU, HARRY SANDOVAL (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:SANDOVAL
Last Name:YU
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:PO BOX 2126
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35056-2126
Mailing Address - Country:US
Mailing Address - Phone:256-255-2500
Mailing Address - Fax:256-255-2501
Practice Address - Street 1:1750 AL HIGHWAY 157
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-3622
Practice Address - Country:US
Practice Address - Phone:256-255-2500
Practice Address - Fax:256-255-2501
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00026329174400000X
IN01078893A207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM22404081OtherMEDICARE
ALP00279232OtherRAILROAD MEDICARE
AL051555986Medicaid
IN300004241Medicaid
AL51001715OtherBC/BS OF ALABAMA
AL051555986Medicaid
ALP00279232OtherRAILROAD MEDICARE