Individual
DR. DONALD J TYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
756 PIPESTONE ST, BENTON HARBOR, MI 49022-4845
(269) 926-8535
(269) 926-8528
Mailing address
756 PIPESTONE ST, BENTON HARBOR, MI 49022-4845
(269) 926-8535
(269) 926-8528
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301065652
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06103A
BERRIEN HEALTH PLAN
MI
01
—
11-01-11-04-82
BCBS
MI
01
—
11583
HEATH PLAN OF MICHIGAN
MI
01
—
412153406100
COMMUNITY CHOICE OF MI
MI
05
—
4662247-10
—
MI
01
—
7338232
AETNA
MI
01
—
OPO3540
MEDICARE GROUP BUSINESS NUMBER
MI
Enumeration date
12/07/2005
Last updated
03/20/2019
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