MEDICARE: MR. MICHAEL ANTHONY SYLVA 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
1	174400000X	Specialist	D0034109	MD

General Provider Information

NPI Number	:	1770589871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL ANTHONY SYLVA M.D.

Provider Business Mailing Address
First Line	:	8096 EDWIN RAYNOR BLVD STE D
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-6837
Country	:	US
Telephone Number	:	410-255-5525
Fax Number	:	410-255-3323

Provider Business Practice Location Address
First Line	:	8096 EDWIN RAYNOR BLVD STE D
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-6837
Country	:	US
Telephone Number	:	410-255-5525
Fax Number	:	410-255-3323

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	10/22/2007

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