Provider Demographics
NPI:1770511685
Name:YOST, MONIQUE R (MD)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:R
Last Name:YOST
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 1:750 KINGS HWY STE 103
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1772
Mailing Address - Country:US
Mailing Address - Phone:302-550-8100
Mailing Address - Fax:302-550-8105
Practice Address - Street 1:750 KINGS HWY STE 103
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1772
Practice Address - Country:US
Practice Address - Phone:302-550-8100
Practice Address - Fax:302-550-8105
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0007914207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000039712Medicaid
DE019396M11Medicare PIN
I02023Medicare UPIN