Healthcare Provider Details

I. General information

NPI: 1710198833
Provider Name (Legal Business Name): ANTOINETTE BYRD-CARR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E MICHIGAN AVE SUITE 700
LANSING MI
48912-1800
US

IV. Provider business mailing address

1200 E MICHIGAN AVE SUITE 700
LANSING MI
48912-1800
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-5888
  • Fax: 517-364-5889
Mailing address:
  • Phone: 517-364-5888
  • Fax: 517-364-5889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number4301088427
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: