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General NPI Number Information
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NPI Number | 1659500411
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Entity Type | Individual
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Provider Name | MICHAEL SCOTT CYRA PSYCHIATRIC NP
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Gender | Male
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 7950 MARTIN LOOP MARTIN ARMY COMMUNITY HOSPITAL
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City | FT. BENNING
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State | GA
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Zip | 31905
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Country | US
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Telephone | 706-544-4915
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Fax |
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Provider Business Mailing Address
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Address Line | MARTIN ARMY COMMUNITY HOSPITAL 7950 MARTIN LOOP
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City | FT. BENNING
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State | GA
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Zip | 31905
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Country | US
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Telephone | 706-544-4915
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | YET TO BE GIVEN
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License Number State | UT
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