Provider Demographics
NPI:1851822787
Name:GARLAND, MYRIAM ANDREA (MD)
Entity Type:Individual
Prefix:
First Name:MYRIAM
Middle Name:ANDREA
Last Name:GARLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MYRIAM
Other - Middle Name:ANDREA
Other - Last Name:CALVO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1490
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-1490
Mailing Address - Country:US
Mailing Address - Phone:336-835-7337
Mailing Address - Fax:
Practice Address - Street 1:1925 N BRIDGE ST STE 101
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2105
Practice Address - Country:US
Practice Address - Phone:336-835-7337
Practice Address - Fax:336-835-7301
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2022-02103208000000X
390200000X
TXS6399208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program