Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 0101045693 | VA |
Y | 207X00000X | Orthopaedic Surgeon | D0040832 | MD |
N | 207X00000X | Orthopaedic Surgeon | MD19079 | DC |
NPI | 1013948488 |
---|---|
Provider Name | Dr. John Philip Byrne |
First Address | Clinton, MD 20735 |
Second Address | Clinton, MD 20735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 07/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200028340 | RAILROAD MEDICARE (01) | MD |
46950009 | BCBS PROVIDER # (01) | DC |
52 1054342 | TAX ID # (01) | |
E61710 | (02) |