Provider Demographics
NPI:1841252970
Name:YANCHIK, LORI MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:MICHELLE
Last Name:YANCHIK
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-8460
Mailing Address - Fax:704-384-8465
Practice Address - Street 1:1994 WELLNESS BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-7767
Practice Address - Country:US
Practice Address - Phone:704-384-8460
Practice Address - Fax:704-384-8465
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA079239208000000X
NC200701328208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5907476Medicaid