Provider Demographics
NPI:1790045086
Name:KULYAK, YURIY (MD)
Entity Type:Individual
Prefix:
First Name:YURIY
Middle Name:
Last Name:KULYAK
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 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:980-302-3050
Mailing Address - Fax:980-302-3055
Practice Address - Street 1:8201 HEALTHCARE LOOP STE 305
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-7072
Practice Address - Country:US
Practice Address - Phone:980-302-3050
Practice Address - Fax:980-302-3055
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20-37944207R00000X
NC2016-01179208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine