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DR. VASSILIA D YOUNG MD

Physicians Dermatology

Provider NPI: 1750353389

Provider Information:
DR. VASSILIA D YOUNG MD
Gender: F
Not Sole Proprietor

Practice Location:
7236 JORDAN DR STE 101  RAPID CITY, SD 57702-8740 US
Tel: 605-341-5565  Fax: 605-341-5595

Business Mailing Address:
PO BOX 6540  RAPID CITY, SD 57709-6540 US
Tel: 605-341-5565  Fax: 605-341-5595

NPI Information:
NPI: 1750353389
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207N00000XPhysicians
Dermatology
SD4069
N207ND0101XPhysicians
Dermatology
SD4069
N207ND0900XPhysicians
Dermatology
SD4069
N207NP0225XPhysicians
Dermatology
SD4069
N207NS0135XPhysicians
Dermatology
SD4069

Other Provider Identifiers:

IssuerNumberStateType
5900103SD05
WELLMARK BCBS NUMBER0040886SD01
116997100WY05
WYOMING BCBS NUMBER311267WY01
46046131400NE05
TRICARE NUMBER460461314SD01



American Medical Association 2012 taxonomy code information

Code: 207N00000X

Type:

Classification:



Definition:



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