Provider Demographics
NPI:1205236536
Name:VERDIEU, YVES CHRISTIAN (PA-C)
Entity type:Individual
Prefix:
First Name:YVES
Middle Name:CHRISTIAN
Last Name:VERDIEU
Suffix:
Gender:
Credentials:PA-C
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 936857
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-6857
Mailing Address - Country:US
Mailing Address - Phone:910-662-6600
Mailing Address - Fax:910-332-0246
Practice Address - Street 1:1333 S DICKINSON DR UNIT 230
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-6434
Practice Address - Country:US
Practice Address - Phone:910-662-6600
Practice Address - Fax:910-550-3787
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017524363AM0700X
NC0010-09230363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical