Active NPI
Haig Yardumian, D. O.
- Medical Oncology Physician
- Decatur, GA
National Provider Identifier
1720200504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Oncology Physician
- License
- 053454
- Practice address
- 150 E Ponce de Leon Ave
Suite 120
Decatur, GA 30030-2543 - Phone
- (800) 998-5859
- Fax
- (404) 378-7460
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Oncology Physician | 207RX0202X | 053454 | FL | Primary |
Addresses
Primary practice location
150 E Ponce de Leon Ave
Suite 120
Decatur, GA 30030-2543
Mailing address
150 E Ponce de Leon Ave
Suite 120
Decatur, GA 30030-2543
Phone (800) 998-5859
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3454 | FL | MD | Chiropractor |
| 053454 | FL | MD | Medical Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millennium Medical Inc | Past | Accepting new patients | |
| Cardiothoracic Surgery of Hyde Park Inc | Past | Accepting new patients | |
| Palm Harbor Westchase Medical Group PA | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- St Petersburg, FL
- NPI 1093024333
-
- Family Medicine Physician
- St Petersburg, FL
- NPI 1023047107
-
- Internal Medicine Physician
- Palm Harbor, FL
- NPI 1740498310
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720200504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 E PONCE DE LEON AVE",
"address_2": "SUITE 120",
"city": "DECATUR",
"state": "GA",
"postal_code": "300302543",
"telephone_number": "800-998-5859",
"fax_number": "404-378-7460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 E PONCE DE LEON AVE",
"address_2": "SUITE 120",
"city": "DECATUR",
"state": "GA",
"postal_code": "300302543",
"telephone_number": "800-998-5859",
"fax_number": "404-378-7460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YARDUMIAN",
"first_name": "HAIG",
"name_prefix": "Dr.",
"credential": "D. O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "FL",
"license": "053454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.