Individual
DR. ADOLPH RALPH YANIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5490 BROADWAY, SUITE 105, MERRILLVILLE, IN 46410-1675
(219) 884-3210
(219) 884-3244
Mailing address
5490 BROADWAY, SUITE 105, MERRILLVILLE, IN 46410-1675
(219) 884-3210
(219) 884-3244
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
010380025A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000088069
BLUE CROSS BLUE SHIELD
IN
05
—
100201270A
—
IN
Enumeration date
01/10/2007
Last updated
03/19/2010
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