Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | D58762 | MD |
NPI | 1972680262 |
---|---|
Provider Name | Kevin D Mcbryde |
First Address | Bethesda, MD 20892-4878 |
Second Address | Bethesda, MD 20892-2089 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 16/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G55815 | (02) |