Provider Demographics
NPI:1255114435
Name:YEHYA, MARWAN
Entity type:Individual
Prefix:
First Name:MARWAN
Middle Name:
Last Name:YEHYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 PERKINS ST
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-1938
Mailing Address - Country:US
Mailing Address - Phone:517-617-0216
Mailing Address - Fax:
Practice Address - Street 1:620 E CHICAGO RD
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-9497
Practice Address - Country:US
Practice Address - Phone:517-279-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53024154761835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy