Basic Information
Provider Information
NPI: 1548367790
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YARMUS
FirstName: LONNY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 64264
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212644264
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 600 N WOLFE ST
Address2: 18310 BLDG, 5TH FLOOR
City: BALTIMORE
State: MD
PostalCode: 212870005
CountryCode: US
TelephoneNumber: 4109553467
FaxNumber: 4109550036
Other Information
ProviderEnumerationDate: 09/20/2006
LastUpdateDate: 01/05/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XH0068282MDY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RC0200XH0068282MDN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207R00000XH0068282MDN Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
41778350005MD MEDICAID


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