| Doctor Name: | DR. BRIAN C BYRNE |
| NPI Number: | 1376863308 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 11015526A |
| Business Practice Address: | 1111 Ronald Reagan Pkwy Avon, IN - 461237085 |
| Business Phone Number: | 3172173500 |
| Business Fax Number: | 3172173115 |
| Mailing Address: | 950 N Meridian St, Ste 500 Provider Enrollment INDIANAPOLIS |
| State: | IN |
| Postal Code: | 462043908 |
| Phone Number: | 3179630860 |
| Fax Number: | 3179624950 |
| NPI Enumeration Date: | 06/01/2010 |
| NPI Last Update Date: | 11/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | 11015526A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |