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Individual

KELLY A WYPYCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
600 N WOLFE ST, BALTIMORE, MD 21264-2515
(410) 955-5080
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6340

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
008902
NY
363A00000X
Physician Assistant
Primary
C05488
MD
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
001001210
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8102445
NC
05
984044300
MD
Enumeration date
02/27/2007
Last updated
05/09/2025
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