Provider Demographics
NPI:1982663225
Name:BYERS, STACIE (DO)
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:
Last Name:BYERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 UNIVERSITY PL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2605
Mailing Address - Country:US
Mailing Address - Phone:412-383-1800
Mailing Address - Fax:412-383-1807
Practice Address - Street 1:119 UNIVERSITY PL
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2605
Practice Address - Country:US
Practice Address - Phone:412-383-1800
Practice Address - Fax:412-383-1807
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO46698207P00000X
PAOS009824L207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00671631OtherRR MEDICARE
PA001791394Medicaid
CO80954537Medicaid
PA001791394Medicaid
COP00671631OtherRR MEDICARE
0000029705Medicare ID - Type Unspecified