Provider Demographics
NPI:1407803893
Name:PYLMAN, MICHAEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:PYLMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8524 W GAGE BLVD
Mailing Address - Street 2:BLDG A1 BOX 319
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-8241
Mailing Address - Country:US
Mailing Address - Phone:509-591-0070
Mailing Address - Fax:509-396-9661
Practice Address - Street 1:3820 COMMONS AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-5831
Practice Address - Country:US
Practice Address - Phone:505-933-7799
Practice Address - Fax:509-783-6655
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2020-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ORMD20589207LP2900X
ND13018207LP2900X
NMMD2015-0259207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM28838394Medicaid
OR050922021OtherBLUE CROSS
OR150129Medicaid
OR97420A018OtherTRICARE
ORC105025OtherPACIFIC SOURCE
050087352OtherRAILROAD MEDICARE
050087352OtherRAILROAD MEDICARE