MEDICARE: MICHAEL DYER SR. LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	G12560	MD

General Provider Information

NPI Number	:	1205518974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL DYER SR. LMSW

Provider Business Mailing Address
First Line	:	5277 GREEN HILL CIR
Second Line	:
City	:	QUANTICO
State	:	MD
Zip	:	21856-2053
Country	:	US
Telephone Number	:	410-430-2517
Fax Number	:

Provider Business Practice Location Address
First Line	:	5277 GREEN HILL CIR
Second Line	:
City	:	QUANTICO
State	:	MD
Zip	:	21856-2053
Country	:	US
Telephone Number	:	410-430-2517
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2023
Last Update Date	:	08/02/2023

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