Provider Demographics
NPI:1356399877
Name:CAMPBELL, BYRON D II (MD)
Entity type:Individual
Prefix:DR
First Name:BYRON
Middle Name:D
Last Name:CAMPBELL
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:2845 CAPITAL AVE SW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-4185
Mailing Address - Country:US
Mailing Address - Phone:269-969-6177
Mailing Address - Fax:269-969-8776
Practice Address - Street 1:2845 CAPITAL AVE SW
Practice Address - Street 2:SUITE 201
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4185
Practice Address - Country:US
Practice Address - Phone:269-969-6177
Practice Address - Fax:269-969-8776
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2016-10-12
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Provider Licenses
StateLicense IDTaxonomies
MI0498242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1356399877Medicaid
A74850Medicare UPIN
MICN7211OtherRAILROAD MEDICARE GROUP
MI0M37350Medicare PIN
MI0A31027OtherBLUE CROSS BLUE SHIELD
MI130018191OtherRAILROAD MEDICARE
MI1301300351OtherBLUE CROSS BLUE SHIELD INDIVIDUAL PIN