Provider Demographics
NPI:1710152467
Name:BYRNE, MARK WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:WILLIAM
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 1:81 HIGHLAND AVE
Mailing Address - Street 2:SALEM HOSPITAL, DEPARTMENT OF EMERGENCY MEDICINE
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2714
Mailing Address - Country:US
Mailing Address - Phone:978-354-3517
Mailing Address - Fax:978-740-4731
Practice Address - Street 1:81 HIGHLAND AVE
Practice Address - Street 2:SALEM HOSPITAL, DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2714
Practice Address - Country:US
Practice Address - Phone:978-354-3517
Practice Address - Fax:978-740-4731
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229091207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110072263AMedicaid
MA110072263AMedicaid