Provider Demographics
NPI:1790723401
Name:YODER, MAGDALENA G (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGDALENA
Middle Name:G
Last Name:YODER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MAGDALINA
Other - Middle Name:J
Other - Last Name:GUNARATNAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:213 S JEFFERSON ST STE 1006
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24011-1713
Mailing Address - Country:US
Mailing Address - Phone:540-224-5715
Mailing Address - Fax:
Practice Address - Street 1:4461 STARKEY RD STE 201
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-0622
Practice Address - Country:US
Practice Address - Phone:540-342-0585
Practice Address - Fax:540-982-1764
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237878207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1434305OtherCIGNA
VA010268877Medicaid
VA1790723401Medicaid
VA7289822OtherAETNA
P00679644OtherRAILROAD MEDICARE
VA221272OtherANTHEM
VA449813OtherSOUTHERN HEALTH
VAP00324081OtherRAILROAD MEDICARE
VA010268877Medicaid
I55736Medicare UPIN
VA1790723401Medicaid