Healthcare Provider Details

I. General information

NPI: 1134109580
Provider Name (Legal Business Name): CATHERINE ANNE KIMBALL-EAYRS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE WRNMMC, DEPT OF PEDS
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

8901 WISCONSIN AVE WRNMMC, DEPT OF PEDS
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-295-7851
  • Fax: 301-295-6173
Mailing address:
  • Phone: 301-295-7851
  • Fax: 301-295-6173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD418580
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: