Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | H0069168 | MD |
Y | 2081P2900X | Pain Medicine | H0069168 | MD |
NPI | 1205981867 |
---|---|
Provider Name | Dr. Michael A. Gardyn |
First Address | Baltimore, MD 21237 |
Second Address | Baltimore, MD 21237-4329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 28/10/2020 |