Individual
MARK A. YODER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
830 HARRISON AVE, MOAKLEY LL100, BOSTON, MA 02118
(617) 638-7070
Mailing address
801 ALBANY STREET, FL GROUND, BOSTON, MA 02119
(617) 414-5405
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
172032
MA
363LF0000X
Family Nurse Practitioner
Primary
172032
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110041072A
—
MA
05
—
2104849
—
MA
Enumeration date
05/04/2006
Last updated
11/03/2020
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