Provider Demographics
NPI:1023094091
Name:BYERLY, AMY M (DO)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:M
Last Name:BYERLY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7740 WASHNGTON VLG DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4056
Mailing Address - Country:US
Mailing Address - Phone:937-531-7900
Mailing Address - Fax:937-531-7901
Practice Address - Street 1:7740 WASHINGTON VILLAGE DR STE 100
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-3994
Practice Address - Country:US
Practice Address - Phone:379-433-4325
Practice Address - Fax:937-439-7445
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007414207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH34007414BOtherMEDICAL LICENSE
OH421534506070OtherCARESOURCE
OH000000290784OtherUNICARE
OHP00047033OtherRAILROAD MEDICARE
OH0704300OtherUNITED HEALTH CARE
OH2205492Medicaid
OH7700448OtherAETNA
OHD0741403OtherHUMANA/CHOICECARE
OH000000290784OtherANTHEM
OHD0741402OtherHUMANA/CHOICECARE
OH34007414BOtherMEDICAL LICENSE
OHH25599Medicare UPIN
OH000000290784OtherANTHEM
OH2205492Medicaid