C Yadmark MD PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301063359 Issued in MI

Legal business name

C YADMARK MD PLLC

Practice address

31610 Plymouth Rd
Livonia, MI 48150

Phone

(734) 421-2840

Fax

(734) 421-4045

NPI assigned

Jul 26, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chuck Yadmark, MDNPI 1891803029

Title

President

Phone

(734) 883-1334

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chuck Yadmark, MD

  • Internal Medicine Physician
  • Livonia, MI
  • NPI 1891803029
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532563200000",
    "number": "1639656184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31610 PLYMOUTH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501932",
            "telephone_number": "734-421-2840",
            "fax_number": "734-421-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31610 PLYMOUTH RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48150",
            "telephone_number": "734-421-2840",
            "fax_number": "734-421-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C YADMARK MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A",
        "authorized_official_last_name": "YADMARK",
        "authorized_official_first_name": "CHUCK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-883-1334",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301063359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "4301063359",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Livonia, MI
• Providers in Livonia, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.