LYLE T. MODLIN DPM PA NPI 1134251895

NPI Information

LYLE T. MODLIN, DPM PA is a foot and ankle surgery podiatrist in Annapolis, MD. LYLE T. MODLIN, DPM PA NPI is 1134251895. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

43 OLD SOLOMONS ISLAND RD
SUITE 102
ANNAPOLIS, MD
ZIP 21401-850
Phone: (410) 263-3100
Fax: (410) 263-7380

The provider's authorized official is Reneau Zepp .
The authorized official title is Office Manager and has the following contact phone number (410) 263-3100.

The enumeration date for this NPI number is 3/9/2007 and was last updated on 7/7/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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