Provider Demographics
NPI:1770116493
Name:GRESS, KYLE L (MD)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:L
Last Name:GRESS
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 1:3800 RESERVOIR ROAD NW
Mailing Address - Street 2:DEPT OF SURGERY
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007
Mailing Address - Country:US
Mailing Address - Phone:202-444-5022
Mailing Address - Fax:202-444-7987
Practice Address - Street 1:3800 RESERVOIR ROAD NW
Practice Address - Street 2:DEPT OF SURGERY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007
Practice Address - Country:US
Practice Address - Phone:202-444-5022
Practice Address - Fax:202-444-7987
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-20
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program