NPI 1508161894

Gary a Byrum, IDC

Practitioner Independent Duty Corpsman Indian Head, MD

Practice location

Address: 2008 Stump Neck Rd Naval Explosive Ordnance Disposal Technology Division, Indian Head, MD 20640-5070
Phone: (757) 375-2160
Mailing address: 2008 Stump Neck Rd Naveodtecdiv, Indian Head, MD 20640-5070

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1508161894
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Jan 2011
Record last updated: 18 Jan 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.