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General NPI Number Information
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NPI Number | 1699039206
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Entity Type | Organization
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Legal Business Name | MAX M BAYARD MD PC
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Dates
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Enumeration Date | 06/28/2012
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Last Update Date | 10/12/2012
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Provider Practice Location Address
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Address Line | 77 FAIRFIELD ST
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City | SAINT ALBANS
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State | VT
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Zip | 05478-1716
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Country | US
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Telephone | 802-527-4151
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Fax | 802-528-2075
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Provider Business Mailing Address
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Address Line | 77 FAIRFIELD ST
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City | SAINT ALBANS
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State | VT
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Zip | 05478-1716
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Country | US
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Telephone | 802-527-4151
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Fax | 802-528-2075
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Authorized Official
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Title or Position | OWNER OF PRACTICE
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Name | MAX BAYARD
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Credential | MD
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Telephone | 802-527-4151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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