Hyatt, Bruce Irvin
Hyatt, Bruce Irvin is an sole proprietor health care provider with primary practice located at 409 W Cold Spring Lane , Baltimore MD 21210-2845. He recently has 6 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Low Vision Rehabilitation, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Corneal and Contact Management is his primary health care specialty. Hyatt, Bruce Irvin can be contacted via phone (410) 243-8884.Contact Information
Primary practice address
409 W Cold Spring Lane
Baltimore MD 21210-2845
Phone: (410) 243-8884
Fax: (410) 243-5656
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | TAO749 | Maryland |
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | TAO749 | Maryland |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | TAO749 | Maryland |
| Eye and Vision Services Providers / Sports Vision | 152WS0006X | TAO749 | Maryland |
| Eye and Vision Services Providers / Vision Therapy | 152WV0400X | TAO749 | Maryland |
| Eye and Vision Services Providers / Occupational Vision | 152WX0102X | TAO749 | Maryland |
Profile Details
| NPI number | 1649231101 |
|---|---|
| LBN Legal business name | Hyatt, Bruce Irvin |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 31st, 2006 |
| Last updated | Nov 18th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649231101 | NPPES |
| Maryland | MEDICAID | 158700500 |
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