Provider Demographics
NPI:1467469197
Name:BYRD, DAVID ROGER (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROGER
Last Name:BYRD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:405 BARCLAY CIR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-4573
Mailing Address - Country:US
Mailing Address - Phone:248-293-0800
Mailing Address - Fax:248-853-3275
Practice Address - Street 1:405 BARCLAY CIR
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4573
Practice Address - Country:US
Practice Address - Phone:248-293-0800
Practice Address - Fax:248-853-3275
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2014-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301067857207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI070F322730OtherBLUE CROSS BLUE SHIELD
MI0P55960OtherMEDICARE
MI5607758OtherAETNA PROVIDER
MI070016389OtherRAILROAD MEDICARE