Provider Demographics
NPI:1124006671
Name:BYARS, CHAD (MD)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:BYARS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9155 SW BARNES RD
Mailing Address - Street 2:SUITE 420
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6625
Mailing Address - Country:US
Mailing Address - Phone:503-297-6334
Mailing Address - Fax:503-297-2360
Practice Address - Street 1:10150 SE 32ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97222-6516
Practice Address - Country:US
Practice Address - Phone:503-513-1031
Practice Address - Fax:503-513-8469
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35075203207P00000X
ORMD27144207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2138332Medicaid
OH2138332Medicaid
OH4040361Medicare PIN
OHG96354Medicare UPIN
OH4040363Medicare PIN