Provider Demographics
NPI:1396883278
Name:NYMAN, GARY WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:WILLIAM
Last Name:NYMAN
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 1:331 TUSCANY RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-2934
Mailing Address - Country:US
Mailing Address - Phone:410-662-6631
Mailing Address - Fax:
Practice Address - Street 1:2 HAMILL RD
Practice Address - Street 2:# 354
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210-1806
Practice Address - Country:US
Practice Address - Phone:410-662-6631
Practice Address - Fax:410-889-9969
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00017262084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine