Healthcare Provider Details

I. General information

NPI: 1790773166
Provider Name (Legal Business Name): MICHAEL A BYARS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3152 PORT SHELDON ST SUITE C
HUDSONVILLE MI
49426-9297
US

IV. Provider business mailing address

3152 PORT SHELDON ST SUITE C
HUDSONVILLE MI
49426-9297
US

V. Phone/Fax

Practice location:
  • Phone: 616-669-9238
  • Fax: 616-669-8296
Mailing address:
  • Phone: 616-669-9238
  • Fax: 616-669-8296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301060147
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: