Provider Demographics
NPI:1932196557
Name:YAROCH, JULIE K (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:K
Last Name:YAROCH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:781 LAKESHIRE TRL
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-1561
Mailing Address - Country:US
Mailing Address - Phone:517-265-0600
Mailing Address - Fax:517-263-0024
Practice Address - Street 1:781 LAKESHIRE TRL
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-1561
Practice Address - Country:US
Practice Address - Phone:517-263-2187
Practice Address - Fax:517-263-0024
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101013140207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4115464Medicaid
MIM35150080Medicare PIN
MI0M86930Medicare ID - Type Unspecified
MIH03000Medicare UPIN