Provider Demographics
NPI:1003083080
Name:LOUIS F BYRNE MD PC
Entity Type:Organization
Organization Name:LOUIS F BYRNE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-793-4471
Mailing Address - Street 1:4386 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-4067
Mailing Address - Country:US
Mailing Address - Phone:989-793-4471
Mailing Address - Fax:989-793-6680
Practice Address - Street 1:4386 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-4067
Practice Address - Country:US
Practice Address - Phone:989-793-4471
Practice Address - Fax:989-793-6680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301033205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0876381OtherHEALTH PLUS OF MICHIGAN
MI1066750Medicaid
MI0737638OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI0737638Medicare PIN
MI0737638OtherBLUE CROSS BLUE SHIELD OF MICHIGAN