Healthcare Provider Details

I. General information

NPI: 1306967807
Provider Name (Legal Business Name): DRS BYERS & BIRNBAUM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35040 CHARDON RD STE G200
WILLOUGHBY OH
44094-9055
US

IV. Provider business mailing address

35040 CHARDON RD STE G200
WILLOUGHBY OH
44094-9055
US

V. Phone/Fax

Practice location:
  • Phone: 440-953-9014
  • Fax: 440-953-9173
Mailing address:
  • Phone: 440-953-9014
  • Fax: 440-953-9173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number47631
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number39718
License Number StateOH

VIII. Authorized Official

Name: EVA MCGREGOR
Title or Position: OFFICE MANAGER
Credential:
Phone: 440-953-9014