Provider Demographics
NPI:1710195664
Name:JOHN E. MYHILL, PH.D., P.A.
Entity Type:Organization
Organization Name:JOHN E. MYHILL, PH.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:MYHILL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-266-0070
Mailing Address - Street 1:PO BOX 1092
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-8092
Mailing Address - Country:US
Mailing Address - Phone:410-266-0070
Mailing Address - Fax:410-647-9386
Practice Address - Street 1:507 WEST DR
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2623
Practice Address - Country:US
Practice Address - Phone:410-266-0070
Practice Address - Fax:410-647-9386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01575103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB362Medicare ID - Type Unspecified