Provider Demographics
NPI:1710275177
Name:BYRNE, TARA K (MD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:K
Last Name:BYRNE
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1096 SOUTH CENTER ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48509-1948
Mailing Address - Country:US
Mailing Address - Phone:810-743-3351
Mailing Address - Fax:
Practice Address - Street 1:1096 S BELSAY RD
Practice Address - Street 2:SUITE C
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1948
Practice Address - Country:US
Practice Address - Phone:810-743-3351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301099437207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine