Provider Demographics
NPI:1740263243
Name:YEOMANS, MATTHEW M (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:M
Last Name:YEOMANS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2001 COOLIDGE RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1378
Mailing Address - Country:US
Mailing Address - Phone:517-337-0316
Mailing Address - Fax:517-337-1779
Practice Address - Street 1:2001 COOLIDGE RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1378
Practice Address - Country:US
Practice Address - Phone:517-337-1668
Practice Address - Fax:517-337-1779
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2023-08-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301052775207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI200000001069OtherPHPMM
MI4301052775OtherSTATE LICENSE
MI180023413OtherRAILROAD MEDICARE
MI3159080Medicaid
MI180023413OtherRAILROAD MEDICARE
MIMY052775OtherSTATE LICENSE NUMBER