Basic Information
| Provider Information | |||||||||
| NPI: | 1659477131 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BYCK | ||||||||
| FirstName: | HAL | ||||||||
| MiddleName: | C. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | NEMOURS CHILDRENS CLINIC | ||||||||
| Address2: | P.O. BOX 404112 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303840001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9043903610 | ||||||||
| FaxNumber: | 9042885890 | ||||||||
| Practice Location | |||||||||
| Address1: | NEMOURS PEDIATRICS JESSUP ST. | ||||||||
| Address2: | 1602 JESSUP STREET | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198024210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3025765050 | ||||||||
| FaxNumber: | 3025765065 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 01/06/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | C10003946 | DE | N | Allopathic & Osteopathic Physicians | Pediatrics | 208D00000X | C10003946 | DE | Y | Allopathic & Osteopathic Physicians | General Practice | 208M00000X | C10003946 | DE | N | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 5607400 | 05 | NJ | MEDICAID | 6704204 | 05 | VA | MEDICAID | 001447101 | 05 | PA | MEDICAID | 4423030 | 05 | DC | MEDICAID | 1484311 | 05 | MD | MEDICAID |