Provider Demographics
NPI:1356378863
Name:YEH, ERIC M (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:M
Last Name:YEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5720 ROCK DOVE DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-4532
Mailing Address - Country:US
Mailing Address - Phone:419-733-2244
Mailing Address - Fax:
Practice Address - Street 1:5720 ROCK DOVE DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-4532
Practice Address - Country:US
Practice Address - Phone:419-733-2244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37947207V00000X
OH35-081441207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12331538Medicaid
OH1447288717OtherORGANIZATIONAL NPI
OH9934724OtherMEDICARE ORGANIZATIONAL PTAN
OH2821558OtherMEDICAID GROUP
OH2338723Medicaid
OH2338723Medicaid
CO12331538Medicaid
OHYE4090471Medicare PIN