Provider Demographics
NPI:1144649336
Name:ENGLEHART, TROY MICHAEL II (AT)
Entity type:Individual
Prefix:MR
First Name:TROY
Middle Name:MICHAEL
Last Name:ENGLEHART
Suffix:II
Gender:M
Credentials:AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 WALDON ROAD
Mailing Address - Street 2:APT F
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009
Mailing Address - Country:US
Mailing Address - Phone:717-644-2683
Mailing Address - Fax:
Practice Address - Street 1:1401 PULASKI HIGJWAY
Practice Address - Street 2:F
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21009
Practice Address - Country:US
Practice Address - Phone:717-644-2683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA0000206171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor