Provider Demographics
NPI:1710198833
Name:BYRD-CARR, ANTOINETTE (MD)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:
Last Name:BYRD-CARR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E MICHIGAN AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-1800
Mailing Address - Country:US
Mailing Address - Phone:517-364-5888
Mailing Address - Fax:517-364-5889
Practice Address - Street 1:1200 E MICHIGAN AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1800
Practice Address - Country:US
Practice Address - Phone:517-364-5888
Practice Address - Fax:517-364-5889
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301088427207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1710198833Medicaid
MI1710198833Medicaid