Individual
DR. BRIAN C BYRNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 RONALD REAGAN PKWY, AVON, IN 46123-7085
(317) 217-3500
(317) 217-3115
Mailing address
950 N MERIDIAN ST, STE 500 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46204-3908
(317) 963-0860
(317) 962-4950
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01070319A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11015526A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201083530
—
IN
Enumeration date
06/01/2010
Last updated
11/28/2012
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