Organization
ERNESTO T.YUTIAMCO,M.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERNESTO T. YUTIAMCO MD (OWNER/PRESIDENT)
(304) 369-0221
Entity
Organization
Contact information
Practice address
483 MAIN ST, MADISON, WV 25130-1223
(304) 369-0221
(304) 369-0222
Mailing address
PO BOX 428, MADISON, WV 25130-0428
(304) 369-0221
(304) 369-0222
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
13306
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0049816000
—
WV
Enumeration date
08/05/2006
Last updated
08/22/2020
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