MEDICARE: DR. CAROL ANN DYER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	MD15538	DC

General Provider Information

NPI Number	:	1104926609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL ANN DYER MD

Provider Business Mailing Address
First Line	:	2825 ALBEMARLE ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-1037
Country	:	US
Telephone Number	:	202-362-1261
Fax Number	:

Provider Business Practice Location Address
First Line	:	2825 ALBEMARLE ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-1037
Country	:	US
Telephone Number	:	202-362-1261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	01/03/2011

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