Provider Demographics
NPI:1578629580
Name:KYLE, DENISE D (MD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:D
Last Name:KYLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 DUTCHMANS LN
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-3346
Mailing Address - Country:US
Mailing Address - Phone:410-763-8272
Mailing Address - Fax:410-763-6019
Practice Address - Street 1:606 DUTCHMANS LN
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-3346
Practice Address - Country:US
Practice Address - Phone:410-763-8272
Practice Address - Fax:410-763-6014
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0053299208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE113477OtherCOVENTRY
3289510OtherAETNA
8108554OtherUNITED HEALTHCARE GROUP
MD61988101OtherCAREFIRST
620869OtherNCPPO
MD034956OtherPRIORITY PARTNERS
MD61307OtherAMERIGROUP
9964301OtherCIGNA
MDW4320002OtherBLUE CHOICE
DE113477OtherCOVENTRY