Provider Demographics
NPI:1831141852
Name:YARIAN, DAVID O (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:O
Last Name:YARIAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:57 PORTLAND STREET SUITE 2A
Mailing Address - Street 2:
Mailing Address - City:SOUTH BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03908-1203
Mailing Address - Country:US
Mailing Address - Phone:207-384-9212
Mailing Address - Fax:207-384-2008
Practice Address - Street 1:57 PORTLAND ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:SOUTH BERWICK
Practice Address - State:ME
Practice Address - Zip Code:03908-1203
Practice Address - Country:US
Practice Address - Phone:207-384-9212
Practice Address - Fax:207-384-2008
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME014669207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME273840099Medicaid
MEF79828Medicare UPIN
MEMM7075Medicare ID - Type Unspecified