Provider Demographics
NPI:1952362949
Name:YUMIACO, NOEL SICAT (MD)
Entity type:Individual
Prefix:MR
First Name:NOEL
Middle Name:SICAT
Last Name:YUMIACO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3059 S MARYLAND PARKWAY
Mailing Address - Street 2:100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-2315
Mailing Address - Country:US
Mailing Address - Phone:702-732-3441
Mailing Address - Fax:702-732-2310
Practice Address - Street 1:3059 S MARYLAND PARKWAY
Practice Address - Street 2:100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2315
Practice Address - Country:US
Practice Address - Phone:702-732-3441
Practice Address - Fax:702-732-2310
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9169207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV200225019Medicaid
NV200225019Medicaid
NVV32391Medicare PIN