Individual
ROBERT YAMULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
128 WEST 14TH ST, HAZLETON, PA 18201-3266
(570) 455-7677
(570) 455-7627
Mailing address
PO BOX 1347, KINGSTON, PA 18704-0347
(570) 288-8881
(570) 288-8065
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD031594E
PA
207RG0100X
Gastroenterology Physician
Primary
MD031594E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010850580001
—
PA
01
—
072376
FDH
PA
Enumeration date
12/01/2005
Last updated
03/29/2014
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