Provider Demographics
NPI:1184685752
Name:DOYLE, ANDREW JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOSEPH
Last Name:DOYLE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1702 TRANSPORTATION BLVD.
Mailing Address - Street 2:STE I
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114
Mailing Address - Country:US
Mailing Address - Phone:410-721-2500
Mailing Address - Fax:410-721-1308
Practice Address - Street 1:1702 TRANSPORTATION BLVD.
Practice Address - Street 2:STE I
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114
Practice Address - Country:US
Practice Address - Phone:410-721-2500
Practice Address - Fax:410-721-1308
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12264T152W00000X
MDTA1726152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU91925Medicare UPIN