Provider Demographics
NPI:1063703411
Name:BYRD, KATHERINE DOUGLASS (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:DOUGLASS
Last Name:BYRD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 G ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4219
Mailing Address - Country:US
Mailing Address - Phone:202-309-1635
Mailing Address - Fax:
Practice Address - Street 1:20010 CENTURY BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1115
Practice Address - Country:US
Practice Address - Phone:240-686-2300
Practice Address - Fax:240-780-7894
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0079502207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine