Provider Demographics
NPI:1346209442
Name:BYRNE, JEFFREY M (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:BYRNE
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 1:10 ADAMS ST
Mailing Address - Street 2:P.O. BOX 248
Mailing Address - City:N CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-1746
Mailing Address - Country:US
Mailing Address - Phone:978-251-3159
Mailing Address - Fax:978-251-0636
Practice Address - Street 1:10 ADAMS ST
Practice Address - Street 2:
Practice Address - City:N CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-1746
Practice Address - Country:US
Practice Address - Phone:978-251-3159
Practice Address - Fax:978-251-0636
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA49801207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6179932Medicaid
MAJ02782Medicare PIN
MA6179932Medicaid