Provider Demographics
NPI:1740357847
Name:YATES, MICHAEL J (MD ABEM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:YATES
Suffix:
Gender:M
Credentials:MD ABEM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:888 WALKER RD
Mailing Address - Street 2:
Mailing Address - City:LEONARD
Mailing Address - State:MI
Mailing Address - Zip Code:48367-3738
Mailing Address - Country:US
Mailing Address - Phone:248-969-1323
Mailing Address - Fax:248-969-2811
Practice Address - Street 1:888 WALKER RD
Practice Address - Street 2:
Practice Address - City:LEONARD
Practice Address - State:MI
Practice Address - Zip Code:48367-3738
Practice Address - Country:US
Practice Address - Phone:248-969-1323
Practice Address - Fax:248-969-2811
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301048834207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB48237Medicare UPIN