Provider Demographics
NPI:1780298208
Name:DAVIDSON, BRYCE CANYON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:CANYON
Last Name:DAVIDSON
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 1:1822 GARRETT RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-1027
Mailing Address - Country:US
Mailing Address - Phone:443-974-1218
Mailing Address - Fax:
Practice Address - Street 1:1001 YORK RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2516
Practice Address - Country:US
Practice Address - Phone:410-823-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist