Individual
MRS. MICHELLE M YAMADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5201 FREDERICK STREET, SAVANNAH, GA 31405-4501
(912) 351-3030
(912) 351-3039
Mailing address
5201 FREDERICK STREET, SAVANNAH, GA 31405-4501
(912) 351-3030
(912) 351-3039
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
004303
GA
207Y00000X
Otolaryngology Physician
4303
GA
363A00000X
Physician Assistant
Primary
4303
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275998532A
—
GA
01
—
344049
MEDICAID WELLCARE HMO #
GA
Enumeration date
10/17/2006
Last updated
08/02/2024
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