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Individual

DR. PETRONIO C YADAO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
15350 TRENTON RD, SOUTHGATE, MI 48195-2027
(734) 283-4616
(734) 283-5430
Mailing address
85 W HICKORY GROVE RD, BLOOMFIELD HILLS, MI 48304-2113
(734) 283-4616
(734) 283-5430

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301031996
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1062429
MI
Enumeration date
04/25/2006
Last updated
07/08/2007
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