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General NPI Number Information
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NPI Number | 1477670248
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Entity Type | Individual
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Provider Name | DYER P. BILGRAVE PHD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 6525 N CHARLES ST SUITE 237
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City | BALTIMORE
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State | MD
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Zip | 21204-6872
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Country | US
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Telephone | 443-562-8331
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Fax |
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Provider Business Mailing Address
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Address Line | 418 NORTHWAY
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City | BALTIMORE
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State | MD
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Zip | 21218-1115
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Country | US
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Telephone | 443-562-8331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 04014
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 04014
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License Number State | MD
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