Individual
BERNARDO ISRAEL YAHUACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3500 FRANCISCAN WAY, MICHIGAN CITY, IN 46360-0021
(219) 861-8161
(219) 873-9504
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01082335
IN
207X00000X
Orthopaedic Surgery Physician
Primary
01082335A
IN
207X00000X
Orthopaedic Surgery Physician
ME135900
FL
208600000X
Surgery Physician
2013021052
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024856000
—
FL
05
—
300029600
—
IN
01
—
JK454Z
MEDICARE
FL
01
—
S9UWF
BCBS
FL
Enumeration date
06/27/2013
Last updated
01/16/2023
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