Provider Demographics
NPI:1962582155
Name:BYINGTON, DAVID L (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:BYINGTON
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Gender:M
Credentials:DO
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Mailing Address - Street 1:5070 CASCADE RD SE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-8422
Mailing Address - Country:US
Mailing Address - Phone:616-281-9066
Mailing Address - Fax:616-281-0539
Practice Address - Street 1:5070 CASCADE RD SE
Practice Address - Street 2:SUITE 250
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8422
Practice Address - Country:US
Practice Address - Phone:616-281-9066
Practice Address - Fax:616-281-0539
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2011-04-26
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Provider Licenses
StateLicense IDTaxonomies
MI5101010083207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E61896Medicare UPIN
MIP27140003Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER