Healthcare Provider Details
I. General information
NPI: 1407958143
Provider Name (Legal Business Name): JAMES WILLIAM BYERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/02/2006
Last Update Date: 03/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5501 OLD YORK RD KLEIN BLDG. SUITE 410
PHILADELPHIA PA
19141-3018
US
IV. Provider business mailing address
5501 OLD YORK RD SUITE 202 KORMAN
PHILADELPHIA PA
19141-3018
US
V. Phone/Fax
- Phone: 215-456-7180
- Fax: 215-456-7052
- Phone: 215-456-4695
- Fax: 215-456-5926
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VC0200X |
| Taxonomy | Critical Care Medicine (Obstetrics & Gynecology) Physician |
| License Number | MD031470E |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | MD031470E |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: