Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 036130073 | IL |
Y | 208600000X | Surgeon | 036130073 | IL |
NPI | 1013037605 |
---|---|
Provider Name | Jerome Alain Byam |
First Address | Norfolk, VA 23510-1286 |
Second Address | Washington, DC 20032-4623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 03/06/2015 |