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Individual

DR. MICHAEL K HISE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-5720
(410) 328-5685
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-5720
(410) 328-5685

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D20327
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0212134000
WV
05
1437105228
DE
01
351250-01
BLUE CROSS/BLUE SHIELD
MD
05
4419750
DC
05
479871600
MD
05
5849314
VA
Enumeration date
05/25/2006
Last updated
12/19/2023
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