Provider Demographics
NPI:1881744332
Name:DRAWBAUGH, YANINA M (MD)
Entity type:Individual
Prefix:DR
First Name:YANINA
Middle Name:M
Last Name:DRAWBAUGH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:KAISER PERMANENTE MEDICARE ENROL, ATTN: THERESA JACKSON
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-7405
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:6111 EXECUTIVE BOULEVARD
Practice Address - Street 2:KAISER PERMANENTE, PPQA, 6 WEST,
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852
Practice Address - Country:US
Practice Address - Phone:301-255-4000
Practice Address - Fax:301-255-4031
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2014-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101058179207ZC0500X
MDD53926207ZP0102X
DCMD21927207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
006330M92Medicare ID - Type Unspecified
H30557Medicare UPIN