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Individual

DR. PAUL TYMCHENKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
7138 RITCHIE HWY, GLEN BURNIE, MD 21061-2904
(410) 863-0500
(410) 863-0509
Mailing address
9601 PULASKI PARK DR, SUITE 416, MIDDLE RIVER, MD 21220-1409
(410) 933-5678
(410) 933-1823

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
S2092
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11179826
CAQH
MD
01
615844
CAREFIRST
MD
Enumeration date
07/14/2005
Last updated
06/16/2015
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