Provider Demographics
NPI:1255370904
Name:HINES, YVONNE C (MD)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:C
Last Name:HINES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:555 PLEASANT ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2400
Mailing Address - Country:US
Mailing Address - Phone:508-431-5900
Mailing Address - Fax:508-226-9619
Practice Address - Street 1:555 PLEASANT ST
Practice Address - Street 2:SUITE 106
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2400
Practice Address - Country:US
Practice Address - Phone:508-222-1976
Practice Address - Fax:508-226-9619
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2012-05-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA52045207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6173128Medicaid
MA6173128Medicaid