Michael Baly, PH.D.
Individual provider Active NPI Clinical Neuropsychologist · Odenton, MD
NPI 1588040554 · NPPES record last updated Jul 31, 2015
Key facts
- NPI
- 1588040554
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Neuropsychologist 103G00000X
- Practice address
- 1132 Annapolis Rd
Suite 200
Odenton, MD 21113-1647 - Phone
- (410) 874-1813
- Fax
- (410) 874-1818
- NPI assigned
- Jul 31, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 25, 2025 through Jun 25, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | Yes |
Addresses
Primary practice location
1132 Annapolis Rd
Suite 200
Odenton, MD 21113-1647
Mailing address
2931 E Biddle St
Patient Accounting
Baltimore, MD 21213-3939
Phone (443) 923-1886
Other providers in Odenton, MD
- Olufemi Awonuga
- Mary Lum Ayuk
- Jeneba Bah
- Amber Bailey
- Lillian Halle Baker
- Mabel N a Barnes- Yankey
- Brittany Lorelle Bass
- Heather Bavaria
- Beacon Care Services, LLC
- Christina Beeman-Partin
All providers in Odenton, MD · Clinical Neuropsychologist in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.