Individual
GEORGE D YANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
147 MOURNING DOVE DR, CANON CITY, CO 81212-9476
(303) 918-9186
Mailing address
147 MOURNING DOVE DR, CANON CITY, CO 81212-9476
(303) 918-9186
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
48325
CO
207P00000X
Emergency Medicine Physician
5101014623
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
5101014623
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4639679
—
MI
05
—
4639688
—
MI
05
—
4639703
—
MI
05
—
85520284
—
CO
01
—
GY014623
BLUE CROSS BLUE SHIELD
—
01
—
P00158345
RAILROAD MEDICARE
—
Enumeration date
11/23/2005
Last updated
06/01/2021
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