Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 34.013044 | OH |
NPI | 1295024552 |
---|---|
Provider Name | Mr. Timothy Byrnes |
First Address | Poland, OH 44514-3358 |
Second Address | Poland, OH 44514-3358 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2011 |
Last Update Date | 21/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0250308 | (05) | OH |