Individual
CHARLES S YEAGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
29 CLOISTER AVE, EPHRATA, PA 17522-1701
(717) 733-5556
(717) 721-8139
Mailing address
29 CLOISTER AVE, EPHRATA, PA 17522-1701
(717) 733-5556
(717) 721-8139
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002211L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005878970003
—
PA
01
—
01331201
CAPITAL BLUE CROSS
PA
01
—
1517151
GATEWAY
PA
01
—
154506
HIGHMARK BLUE SHIELD
PA
Enumeration date
12/22/2005
Last updated
03/23/2017
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