Provider Demographics
NPI:1952394892
Name:YANTA, MYLES (MD)
Entity Type:Individual
Prefix:DR
First Name:MYLES
Middle Name:
Last Name:YANTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 PROFESSIONAL DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-5068
Mailing Address - Country:US
Mailing Address - Phone:618-463-8578
Mailing Address - Fax:618-463-8666
Practice Address - Street 1:1 PROFESSIONAL DR
Practice Address - Street 2:SUITE 150
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-5068
Practice Address - Country:US
Practice Address - Phone:618-463-8578
Practice Address - Fax:618-463-8666
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-25
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease