Provider Demographics
NPI:1972102606
Name:BYERLY, COLTON DAVID (PHARMD)
Entity Type:Individual
Prefix:
First Name:COLTON
Middle Name:DAVID
Last Name:BYERLY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2429 BELLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-6605
Mailing Address - Country:US
Mailing Address - Phone:412-600-5971
Mailing Address - Fax:
Practice Address - Street 1:2429 BELLWOOD DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-6605
Practice Address - Country:US
Practice Address - Phone:412-600-5971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP454866183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist