MEDICARE: DR. PAUL JOHN CHYZUS

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	5126	MD

General Provider Information

NPI Number	:	1558414284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL JOHN CHYZUS

Provider Business Mailing Address
First Line	:	1003 NORTH POINT BLVD
Second Line	:	SUITE 603
City	:	BALTIMORE
State	:	MD
Zip	:	21224
Country	:	US
Telephone Number	:	410-282-2400
Fax Number	:	410-282-4100

Provider Business Practice Location Address
First Line	:	1003 NORTH POINT BLVD
Second Line	:	SUITE 603
City	:	BALTIMORE
State	:	MD
Zip	:	21224
Country	:	US
Telephone Number	:	410-282-2400
Fax Number	:

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

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	07/08/2007

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