Provider Demographics
NPI:1124225677
Name:BYRNES, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:BYRNES
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 1:501 FAULCONER DR
Mailing Address - Street 2:STE 2D
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4980
Mailing Address - Country:US
Mailing Address - Phone:434-286-2181
Mailing Address - Fax:434-286-7197
Practice Address - Street 1:501 FAULCONER DR
Practice Address - Street 2:STE 2D
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4980
Practice Address - Country:US
Practice Address - Phone:434-286-2181
Practice Address - Fax:434-286-7197
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116019539390200000X
VA01012469862084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program