Individual
DR. ERNESTO T. YUTIAMCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
483 MAIN ST, MADISON, WV 25130-1223
(304) 369-0221
(304) 369-0222
Mailing address
PO BOX 428, MADISON, WV 25130-0428
(304) 369-0221
(304) 369-0222
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
13306
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0049816000
—
WV
Enumeration date
08/05/2006
Last updated
07/08/2007
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