Provider Demographics
NPI:1740200658
Name:BYRNE, LOUIS F (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:F
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 1:5200 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-3713
Mailing Address - Country:US
Mailing Address - Phone:989-793-4250
Mailing Address - Fax:989-793-6880
Practice Address - Street 1:5200 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3713
Practice Address - Country:US
Practice Address - Phone:989-793-4250
Practice Address - Fax:989-793-6880
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI381956277207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1006750 TYPE 10Medicaid
MI0737637Medicare ID - Type Unspecified