Individual
KAIS YEHYAWI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6375 US HIGHWAY 6 STE B, PORTAGE, IN 46368-5218
(219) 762-0400
(219) 762-2460
Mailing address
6375 US HIGHWAY 6 STE B, PORTAGE, IN 46368-5218
(219) 762-0400
(219) 762-2460
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01055547A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200293540A
—
IN
05
—
200350030
—
IN
Enumeration date
06/01/2005
Last updated
08/25/2011
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