Individual
DR. MARY ANN YURKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
833 MICHIGAN ST NE, SUITE 102, GRAND RAPIDS, MI 49503-3523
(616) 459-1440
(616) 459-0313
Mailing address
833 MICHIGAN ST NE, SUITE 102, GRAND RAPIDS, MI 49503-3523
(616) 459-1440
(616) 459-0313
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301066888
MI
207NP0225X
Pediatric Dermatology Physician
4301066888
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070D12389
BLUE CROSS
—
Enumeration date
09/07/2005
Last updated
01/22/2014
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