Provider Demographics
NPI:1366455255
Name:AYRES, DAVID HOWARD (PD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HOWARD
Last Name:AYRES
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 RAZOR STRAP RD
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:MD
Mailing Address - Zip Code:21901-2718
Mailing Address - Country:US
Mailing Address - Phone:410-287-5989
Mailing Address - Fax:
Practice Address - Street 1:723 N BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5309
Practice Address - Country:US
Practice Address - Phone:410-398-4383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7474183500000X
PARP027071L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist