Provider Demographics
NPI:1629214499
Name:CYLUS, LEWIS DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:DENNIS
Last Name:CYLUS
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 1:12002 RIDGE VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1623
Mailing Address - Country:US
Mailing Address - Phone:410-252-1278
Mailing Address - Fax:
Practice Address - Street 1:12002 RIDGE VALLEY DR
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-1623
Practice Address - Country:US
Practice Address - Phone:410-252-1278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD12688207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2598LDOtherBLUE CROSS/BLUE SHIELD PIN
MD089191600Medicaid
MD089191600Medicaid
2598Medicare PIN