GLENN TAKESHI YAMAGATA

GREENSBORO, NC
NPI1598718066
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2085R0204X Radiology Vascular & Interventional Radiology
(Licence: NC  9801565)
Additional Taxonomies2085R0202X Radiology Diagnostic Radiology
(Licence: NC  9801565)
Enumeration Date2006-05-18
Last Update Date2023-03-10
Business Address
GLENN TAKESHI YAMAGATA MD
1331 N ELM ST STE 200
GREENSBORO, NC 27401-6304
Phone number: 336-274-9617
Mailing Address
GLENN TAKESHI YAMAGATA MD
PO BOX 63112
CHARLOTTE, NC 28263-3112
Phone number: 336-274-9617