# WYE OAK CLINIC, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174913677
- **Authorized official:** MR. DAVID ALAN CLINE III (PRESIDENT)
- **Authorized official phone:** (443) 509-3860

## Contact information

- **Practice address:** 1937 LANSDOWNE RD, HALETHORPE, MD 21227
- **Practice address phone:** (410) 536-0555
- **Practice address fax:** (410) 536-0231
- **Mailing address:** 1937 LANSDOWNE RD, HALETHORPE, MD 21227
- **Mailing address phone:** (410) 536-0555
- **Mailing address fax:** (410) 536-0231

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | — |
| 207RI0200X | Infectious Disease Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/04/2015
- **Last updated:** 02/04/2015