Healthcare Provider Details

I. General information

NPI: 1629898010
Provider Name (Legal Business Name): BYRD HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23077 GREENFILED RD STE 255
SOUTHFIELD MI
48075
US

IV. Provider business mailing address

23077 GREENFILED RD STE 255
SOUTHFIELD MI
48075
US

V. Phone/Fax

Practice location:
  • Phone: 248-559-5200
  • Fax: 248-449-6889
Mailing address:
  • Phone: 248-559-5200
  • Fax: 248-449-6889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BERRY BYRD
Title or Position: PRESIDENT
Credential: DPM
Phone: 205-531-9521