Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 47533 | OH |
NPI | 1063406312 |
---|---|
Provider Name | Stephen A Yoder |
First Address | Dublin, OH 43017-0727 |
Second Address | Ashland, OH 44805-8854 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2005 |
Last Update Date | 25/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0488977 | (05) | OH |