Provider Demographics
NPI:1699189258
Name:YEH, JULIE YEA TEEN (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:YEA TEEN
Last Name:YEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 GROVE RD
Mailing Address - Street 2:BALCONY SUITE 5
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4210
Mailing Address - Country:US
Mailing Address - Phone:864-455-7895
Mailing Address - Fax:864-455-7807
Practice Address - Street 1:701 GROVE RD
Practice Address - Street 2:BALCONY SUITE 5
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4210
Practice Address - Country:US
Practice Address - Phone:864-455-7895
Practice Address - Fax:864-455-7807
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60739567208000000X
SCLL36843208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics