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General NPI Number Information
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NPI Number | 1730137803
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Entity Type | Individual
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Provider Name | TIMOTHY JAMES BYRNES MD
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 3990 JOHN R ST HARPER 1 WEBBER CORE
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City | DETROIT
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State | MI
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Zip | 48201
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Country | US
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Telephone | 313-745-2626
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Fax | 313-745-8643
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Provider Business Mailing Address
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Address Line | 1420 STEPHENSON HWY
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City | TROY
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State | MI
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Zip | 48083-1189
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD043579L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4301037836
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License Number State | MI
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