Basic Information
| Provider Information | |||||||||
| NPI: | 1790834299 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EYLER-YEATMAN | ||||||||
| FirstName: | HOLLY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31 ROBINSON RD | ||||||||
| Address2: | |||||||||
| City: | SEVERNA PARK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211462841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105445900 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1106 ANNAPOLIS RD | ||||||||
| Address2: | SUITE 310 | ||||||||
| City: | ODENTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211131637 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4108741400 | ||||||||
| FaxNumber: | 4108741411 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2007 | ||||||||
| LastUpdateDate: | 11/26/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D0065208 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 11653101 | 01 | MD | CAQH NUMBER | OTHER |