Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | 4301067857 | MI |
NPI | 1467469197 |
---|---|
Provider Name | Dr. David Roger Byrd |
First Address | Rochester Hills, MI 48307-4573 |
Second Address | Rochester Hills, MI 48307-4573 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 11/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
070016389 | RAILROAD MEDICARE (01) | MI |
070F322730 | BLUE CROSS BLUE SHIELD (01) | MI |
0P55960 | MEDICARE (01) | MI |
5607758 | AETNA PROVIDER (01) | MI |