Doctor Name: | THOMAS EDWARD BYRNE |
NPI Number: | 1417380718 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 19689 |
Business Practice Address: | 1057 Revolutionary Trl Fairfax, SC - 298277127 |
Business Phone Number: | 8036322561 |
Business Fax Number: | 8036321867 |
Mailing Address: | 1057 Revolutionary Trl, FAIRFAX |
State: | SC |
Postal Code: | 298277127 |
Phone Number: | 8036322561 |
Fax Number: | 8036321867 |
NPI Enumeration Date: | 08/10/2013 |
NPI Last Update Date: | 08/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 19689 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |