Basic Information
| Provider Information | |||||||||
| NPI: | 1518087048 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | BYRNE | ||||||||
| FirstName: | BRENDAN | ||||||||
| MiddleName: | TERENCE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3621 S STATE ST | ||||||||
| Address2: | 700 KMS PLACE | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349362047 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 E MEDICAL CENTER DRIVE | ||||||||
| Address2: | B1 FLOOR UNIVERSITY HOSPITAL RECP EMERGENCY | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481095301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349366666 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2007 | ||||||||
| LastUpdateDate: | 08/20/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 01065539A | IN | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 4301098305 | MI | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207PE0005X | 01065539A | IN | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Undersea and Hyperbaric Medicine |
No ID Information.