Individual
SUSAN M YELICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
85 N GRAND AVE, 2ND FLOOR, FORT THOMAS, KY 41075
(859) 781-2628
(859) 572-4403
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 578-5880
(859) 578-5881
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
37671
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2549451
—
OH
05
—
64056708
—
KY
Enumeration date
04/25/2006
Last updated
08/31/2018
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