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NPI Code Detail

MEDICARE: MICHAEL RAY BYKHOVSKY M.D.

MEDICARE: MICHAEL RAY BYKHOVSKY M.D.
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
12080P0202XPediatric Cardiology PhysicianMD210002121DC
2390200000XStudent in an Organized Health Care Education/Training Program
3207RA0002XAdult Congenital Heart Disease PhysicianMD210002121DC

General Provider Information

NPI Number : 1679816748
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL RAY BYKHOVSKY M.D.
Provider Business Mailing Address
First Line : PO BOX 744785
Second Line :
City : ATLANTA
State : GA
Zip : 30374-4785
Country : US
Telephone Number : 202-476-5000
Fax Number :
Provider Business Practice Location Address
First Line : 111 MICHIGAN AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20010-2916
Country : US
Telephone Number : 202-476-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2013
Last Update Date : 07/05/2022

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