Provider Demographics
NPI:1659315356
Name:REMICK, KYLE N (MD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:N
Last Name:REMICK
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 1:11110 MEDICAL CAMPUS RD STE 143
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-6755
Mailing Address - Country:US
Mailing Address - Phone:301-714-4350
Mailing Address - Fax:
Practice Address - Street 1:11110 MEDICAL CAMPUS RD STE 143
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-6755
Practice Address - Country:US
Practice Address - Phone:301-714-4350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07029700171000000X
TNMD0000042297171000000X
PAMD442554208600000X, 2086S0102X
MDD801562086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No171000000XOther Service ProvidersMilitary Health Care Provider
No208600000XAllopathic & Osteopathic PhysiciansSurgery