Provider Demographics
NPI:1881259497
Name:BYRD, MARKTAVIA DONETTA
Entity type:Individual
Prefix:
First Name:MARKTAVIA
Middle Name:DONETTA
Last Name:BYRD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HAMILTON ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-6305
Mailing Address - Country:US
Mailing Address - Phone:202-790-9839
Mailing Address - Fax:
Practice Address - Street 1:1260 16TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2555
Practice Address - Country:US
Practice Address - Phone:202-826-2324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant