Fedorovich, Yuri
Fedorovich, Yuri is an individual health care provider with primary practice located at 100 Michigan St Ne , Grand Rapids MI 49503-2560. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Fedorovich, Yuri can be contacted via phone (616) 267-1455.Contact Information
Primary practice address
100 Michigan St Ne
Grand Rapids MI 49503-2560
Phone: (616) 267-1455
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 2022018307 | Missouri |
Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 2022018307 | Missouri |
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 4301511888 | Michigan |
Profile Details
NPI number | 1710544408 |
---|---|
LBN Legal business name | Fedorovich, Yuri |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 29th, 2019 |
Last updated | Jul 12th, 2024 - about 5 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1710544408 | NPPES |
Missouri | MEDICAID | 200112348 |
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