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Individual

GARY A BYRUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
2008 STUMP NECK RD, NAVAL EXPLOSIVE ORDNANCE DISPOSAL TECHNOLOGY DIVISION, INDIAN HEAD, MD 20640-5070
(757) 375-2160
Mailing address
2008 STUMP NECK RD, NAVEODTECDIV, INDIAN HEAD, MD 20640-5070
(757) 375-2160

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
01/18/2011
Last updated
01/18/2011
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