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General NPI Number Information
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NPI Number | 1831548569
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Entity Type | Individual
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Provider Name | ANGEL BYRD M.D.,PH.D.
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Gender | Female
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Dates
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Enumeration Date | 06/03/2016
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Last Update Date | 06/03/2016
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Provider Practice Location Address
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Address Line | 601 N CAROLINE ST
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City | BALTIMORE
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State | MD
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Zip | 21287-0006
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Country | US
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Telephone | 401-339-0133
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Fax |
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Provider Business Mailing Address
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Address Line | 910A GLASTONBURY CIR
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City | RIDGELAND
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State | MS
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Zip | 39157-1209
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Country | US
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Telephone | 401-339-0133
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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