Individual
MICHAEL K TYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1640 E SUMNER ST, HARTFORD, WI 53027
(262) 670-4000
(262) 670-4451
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(262) 670-4000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39173
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32538900
—
WI
01
—
P00941509
RR MEDICARE
WI
Enumeration date
08/24/2006
Last updated
09/22/2023
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