Provider Demographics
NPI:1386635985
Name:HYDER, SYED S (MD)
Entity Type:Individual
Prefix:
First Name:SYED
Middle Name:S
Last Name:HYDER
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 1:121-123 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:MARS
Mailing Address - State:PA
Mailing Address - Zip Code:16046-0848
Mailing Address - Country:US
Mailing Address - Phone:724-625-3171
Mailing Address - Fax:724-625-3510
Practice Address - Street 1:121-123 GRAND AVE
Practice Address - Street 2:
Practice Address - City:MARS
Practice Address - State:PA
Practice Address - Zip Code:16046-0848
Practice Address - Country:US
Practice Address - Phone:724-625-3171
Practice Address - Fax:724-625-3510
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD052414L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014812480Medicaid
PA3613848OtherAETNA HMO
PA4651171OtherAETNA PPO PRODUCTS
PA538000OtherHIGHMARK
PA101512OtherUPMC HEALTH PLAN
PAP00061117OtherRAILROAD MEDICARE
PAP00061117OtherRAILROAD MEDICARE
PA538000Medicare ID - Type Unspecified