Provider Demographics
NPI:1710996871
Name:SOLBERG, BYRNE LINCOLN (MD)
Entity Type:Individual
Prefix:DR
First Name:BYRNE
Middle Name:LINCOLN
Last Name:SOLBERG
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 1:414 PAOLI PIKE
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-3311
Mailing Address - Country:US
Mailing Address - Phone:484-596-3943
Mailing Address - Fax:610-296-4915
Practice Address - Street 1:414 PAOLI PIKE
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-3311
Practice Address - Country:US
Practice Address - Phone:484-596-3943
Practice Address - Fax:610-296-4915
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025907E2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA104240801Medicaid
B36829Medicare UPIN
PA104240801Medicaid