Provider Demographics
NPI:1750388179
Name:HUEY, MICHAEL P (PTA)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:HUEY
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 YORK RD
Mailing Address - Street 2:SUITE C-101
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6240
Mailing Address - Country:US
Mailing Address - Phone:410-321-0377
Mailing Address - Fax:410-821-7517
Practice Address - Street 1:1212 YORK RD
Practice Address - Street 2:SUITE C-101
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6240
Practice Address - Country:US
Practice Address - Phone:410-321-0377
Practice Address - Fax:410-821-7517
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA2204208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation