Individual
TYLER MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
251 N 4TH ST, OAKLAND, MD 21550-1375
(301) 533-4000
Mailing address
13806 OLEANDER DR SW, CUMBERLAND, MD 21502-5934
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0008990
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2022
Last updated
09/20/2023
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