# ERNESTO T.YUTIAMCO,M.D.,P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366451700
- **Authorized official:** ERNESTO T. YUTIAMCO MD (OWNER/PRESIDENT)
- **Authorized official phone:** (304) 369-0221

## Contact information

- **Practice address:** 483 MAIN ST, MADISON, WV 25130-1223
- **Practice address phone:** (304) 369-0221
- **Practice address fax:** (304) 369-0222
- **Mailing address:** PO BOX 428, MADISON, WV 25130-0428
- **Mailing address phone:** (304) 369-0221
- **Mailing address fax:** (304) 369-0222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 13306 | WV | Yes |

## Other

- **Enumeration date:** 08/05/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0049816000 | — | WV |