Provider Demographics
NPI:1790834299
Name:EYLER-YEATMAN, HOLLY (MD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:
Last Name:EYLER-YEATMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-2841
Mailing Address - Country:US
Mailing Address - Phone:410-544-5900
Mailing Address - Fax:
Practice Address - Street 1:1106 ANNAPOLIS RD
Practice Address - Street 2:SUITE 310
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1637
Practice Address - Country:US
Practice Address - Phone:410-874-1400
Practice Address - Fax:410-874-1411
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0065208207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD11653101OtherCAQH NUMBER
MD11653101OtherCAQH NUMBER
MD426P849GMedicare PIN