Provider Demographics
NPI:1952105835
Name:LI-YEDICA, ANNMARIE YAKE (MD)
Entity type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:YAKE
Last Name:LI-YEDICA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:ANNMARIE
Other - Middle Name:YAKE
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5760 POOL SIDE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-6119
Mailing Address - Country:US
Mailing Address - Phone:920-889-6625
Mailing Address - Fax:
Practice Address - Street 1:900 N 92ND ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-1202
Practice Address - Country:US
Practice Address - Phone:920-889-6625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program