Provider Demographics
NPI:1316027907
Name:HYLE, MICHAEL A (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:HYLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6530 WALTHER AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-1735
Mailing Address - Country:US
Mailing Address - Phone:410-319-9155
Mailing Address - Fax:410-426-5755
Practice Address - Street 1:6530 WALTHER AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-1735
Practice Address - Country:US
Practice Address - Phone:410-319-9155
Practice Address - Fax:410-426-5755
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0027693207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4749OtherCAREFIRST BLUECROSS BS
0001 GROUPJ260OtherFEDERAL BC BS
MD0001 GROUPJ260OtherBLUE CHOICE
MD0001 GROUPJ260OtherBLUE CHOICE
P00137786Medicare ID - Type UnspecifiedUHC RAILROAD
MD4749OtherCAREFIRST BLUECROSS BS