Organization
C YADMARK MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHUCK YADMARK MD (PRESIDENT)
(734) 883-1334
Entity
Organization
Contact information
Practice address
31610 PLYMOUTH RD, LIVONIA, MI 48150
(734) 421-2840
(734) 421-4045
Mailing address
31610 PLYMOUTH RD, LIVONIA, MI 48150-1932
(734) 421-2840
(734) 421-4045
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301063359
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301063359
STATE MEDICAL LICENSE
MI
Enumeration date
07/26/2018
Last updated
07/26/2018
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