Provider Demographics
NPI:1760556286
Name:YEICH, THOMAS W (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:YEICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 MT. ROSE AVENUE
Mailing Address - Street 2:SUITE B3
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3051
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:717-851-6969
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-2450
Practice Address - Fax:717-851-3469
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301069711207P00000X, 207R00000X
PAMD433478207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA20071757OtherAMERIHEALTH MERCY-WMG
PA3174248OtherMAMSI-WMG
TY069711OtherCHAMPUS-CHAMPUS
TY069711OtherCOMMERCIAL-COMMERCIAL NUMBER
010H262530OtherBLUE CROSS-BLUE CROSS
PA50075710OtherCAPITAL BLUE CROSS WMG
MI462068610Medicaid
PA7839451OtherAETNA
PA1568890OtherGATEWAY-WMG
PA211446OtherJOHNS HOPKINS
PA102084085Medicaid
PA2017833OtherHIGHMARK BLUE SHIELD
H70768Medicare UPIN
PA20071757OtherAMERIHEALTH MERCY-WMG
PA1568890OtherGATEWAY-WMG