Healthcare Provider Details

I. General information

NPI: 1699270975
Provider Name (Legal Business Name): DAVID ALBERT SAYRE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 LINDEN AVE
BALTIMORE MD
21201-4606
US

IV. Provider business mailing address

22 S GREENE ST RM N5W70
BALTIMORE MD
21201-1544
US

V. Phone/Fax

Practice location:
  • Phone: 410-225-8780
  • Fax: 410-225-8766
Mailing address:
  • Phone: 410-328-6662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD91222
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: