Basic Information
| Provider Information | |||||||||
| NPI: | 1750532255 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YASAR | ||||||||
| FirstName: | MUKADDES | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 900 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | BANGOR | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044011900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079073300 | ||||||||
| FaxNumber: | 2079071923 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | BANGOR | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044011900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079073300 | ||||||||
| FaxNumber: | 2079071923 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2008 | ||||||||
| LastUpdateDate: | 12/31/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD19665 | ME | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.