Individual
JAMES GERARD TYBURSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4160 JOHN R ST, SUITE 615, DETROIT, MI 48201-2020
(313) 745-4195
(313) 993-8669
Mailing address
1560 E MAPLE RD, SUITE 400-CREDENTIALING, TROY, MI 48083-1138
(313) 745-4195
(313) 993-8669
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301051853
MI
2086S0102X
Surgical Critical Care Physician
4301051853
MI
Other
Enumeration date
05/31/2006
Last updated
11/03/2016
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