Healthcare Provider Details

I. General information

NPI: 1932763125
Provider Name (Legal Business Name): REBECCA J BYRNES DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2019
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 MUNSON AVE
TRAVERSE CITY MI
49686-3580
US

IV. Provider business mailing address

550 MUNSON AVE
TRAVERSE CITY MI
49686-3580
US

V. Phone/Fax

Practice location:
  • Phone: 231-935-6600
  • Fax:
Mailing address:
  • Phone: 231-935-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101026050
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number5101026050
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: