Organization
LYLE T. MODLIN, DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEAU ZEPP (OFFICE MANAGER)
(410) 263-3100
Entity
Organization
Contact information
Practice address
43 OLD SOLOMONS ISLAND RD, SUITE 102, ANNAPOLIS, MD 21401-3850
(410) 263-3100
(410) 263-7380
Mailing address
43 OLD SOLOMONS ISLAND RD, SUITE 102, ANNAPOLIS, MD 21401-3850
(410) 263-3100
(410) 263-7380
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
00631
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408190100
—
MD
05
—
463068800
—
MD
Enumeration date
03/09/2007
Last updated
07/07/2011
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