Provider Demographics
NPI:1619084712
Name:BYERS-MILLER, LORRAINE (OD)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:
Last Name:BYERS-MILLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8470 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BIRCH RUN
Mailing Address - State:MI
Mailing Address - Zip Code:48415-9461
Mailing Address - Country:US
Mailing Address - Phone:989-624-2020
Mailing Address - Fax:
Practice Address - Street 1:8470 MAIN ST
Practice Address - Street 2:
Practice Address - City:BIRCH RUN
Practice Address - State:MI
Practice Address - Zip Code:48415-9461
Practice Address - Country:US
Practice Address - Phone:989-624-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004311152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI90-0-B5-14570OtherBCBS MI
MIP63100001Medicare PIN