Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | OS3047 | FL |
NPI | 1124241666 |
---|---|
Provider Name | Dr. Michael Harrison Yard |
First Address | Chicago, IL 60673-1263 |
Second Address | Iron River, MI 49935-8509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 18/12/2012 |