Individual
EDWARD HENRY YOB
Active
Individual
EDWARD HENRY YOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2842
OK
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
2842
OK
207NS0135X
Procedural Dermatology Physician
2842
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070015931
RAILROAD MEDICARE
OK
05
—
100025020A
—
OK
Enumeration date
10/18/2005
Last updated
06/16/2011
Update your record
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