1548551278

Everything you always wanted to know about DR. YELDER JEROME SR. PHD PSYD MBA MS MP but were afraid to ask.

DR. YELDER JEROME SR. PHD PSYD MBA MS MP

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Provider Prefix Provider Last Name Provider First Name Provider Suffix Provider Credential
DR. YELDER JEROME SR. PHD PSYD MBA MS MP
Gender:
Male
Enumeration date:
2011-04-28
Last update date:
2017-10-23
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state
273614612 Medicaid none SC
GP7839 Medicaid none SC

Taxonomies

Taxonomy State License Number Primary?
101YA0400X Addiction (Substance Use Disorder) SC 45428 N
101YP1600X Pastoral SC 61388 N
103G00000X Clinical Neuropsychologist SC 573768 N
171000000X Military Health Care Provider SC 159AMP N
171W00000X Contractor SC 73276 N
174H00000X Health Educator SC 73276 N
1835P0018X Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist SC 5768 N
208VP0014X Interventional Pain Medicine SC 159AMP N
103TP0016X Prescribing (Medical) SC 159AMP Y

Phone Numbers

Type Number
Mailing Address Telephone Number 8039371623
Practice Location Address Telephone Number 8039371623
Mailing Address Fax Number 8039371623
Practice Location Address Fax Number 8039371623

Addresses

Type Address City State Postal Country
Mailing Address 1101 BELLEVIEW ST STE 104 COLUMBIA SC 29201 SC
Practice Location Address 1101 BELLEVIEW ST STE 104 COLUMBIA SC 29201 SC

Other NPI Records that share a phone number

NPI Name Address State City
1497285308 CHFS MANAGEMENT SERVICES CORPO
Organization
1101 BELLEVIEW ST STE 104 SC COLUMBIA

Other NPI Records that share an address

NPI Name Address State City
1497285308 CHFS MANAGEMENT SERVICES CORPO
Organization
1101 BELLEVIEW ST STE 104 SC COLUMBIA