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:
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Health care specialties

SpecialtyCodeLicense #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 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710544408 NPPES
Missouri MEDICAID 200112348

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