Provider Demographics
NPI:1942398540
Name:YANG, MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:923 9TH ST
Mailing Address - Street 2:STE B
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310
Mailing Address - Country:US
Mailing Address - Phone:505-437-9900
Mailing Address - Fax:505-437-5500
Practice Address - Street 1:923 NINTH ST
Practice Address - Street 2:STE B
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6467
Practice Address - Country:US
Practice Address - Phone:505-437-9900
Practice Address - Fax:505-437-5500
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM95381207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM9783OtherBCBS
NMF5431Medicaid
NM9783OtherBCBS