Individual
BYRON H SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2945 HAZELWOOD ST STE 310, MAPLEWOOD, MN 55109-1241
(651) 264-1500
(651) 264-1646
Mailing address
2945 HAZELWOOD ST STE 310, MAPLEWOOD, MN 55109-1241
(651) 264-1500
(651) 264-1646
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
48318
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
099565700
—
MN
05
—
191813300
—
MN
05
—
386950400
—
MN
Enumeration date
07/07/2006
Last updated
10/14/2018
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