LYLE T. MODLIN DPM PA NPI 1134251895

NPI Information

  • NPI: 1134251895
  • Provider Name: LYLE T. MODLIN, DPM PA
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Organization
  • Address: 43 OLD SOLOMONS ISLAND RD
    SUITE 102
    ANNAPOLIS, MD
    ZIP 21401
  • Phone: (410) 263-3100

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NPI Details

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213ES0103XPodiatristFoot & Ankle Surgery00631MARYLANDYes

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1408190100MEDICAIDMARYLAND
2388MMEDICARE ID-TYPE UNSPECIFIEDMARYLANDMEDICARE GROUP NUMBER
3539FMEDICARE ID-TYPE UNSPECIFIEDMARYLANDMEDICARE INDIVIDUAL NUMBE
40908620001MEDICARE NSCMARYLAND
5T30829MEDICARE UPINMARYLAND
6463068800MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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