Provider Demographics
NPI:1568822443
Name:HYATT, MICHAEL (DVM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HYATT
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1037
Mailing Address - Country:US
Mailing Address - Phone:856-365-3300
Mailing Address - Fax:
Practice Address - Street 1:1 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1037
Practice Address - Country:US
Practice Address - Phone:856-365-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ29VI00618000174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian