Healthcare Provider Details

I. General information

NPI: 1346426160
Provider Name (Legal Business Name): BYRON PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2008
Last Update Date: 01/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11518 HIGHLAND RD
HARTLAND MI
48353-2722
US

IV. Provider business mailing address

11518 HIGHLAND RD
HARTLAND MI
48353-2722
US

V. Phone/Fax

Practice location:
  • Phone: 810-632-7800
  • Fax: 810-632-7877
Mailing address:
  • Phone: 810-632-7800
  • Fax: 810-632-7877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSB001901
License Number StateMI

VIII. Authorized Official

Name: DR. SCOTT E BYRON
Title or Position: PHYSICIAN AND SURGEON
Credential: DPM
Phone: 810-632-7800