Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 4301065745 | MI |
Y | 111NI0900X | Internist | 4301065745 | MI |
N | 207RI0200X | Infectious Disease | 4301065745 | MI |
NPI | 1043321409 |
---|---|
Provider Name | Dr. Ireneo Yap Diaz JR. |
First Address | Battle Creek, MI 49037-7314 |
Second Address | Battle Creek, MI 49015-1014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 03/09/2020 |