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NPI Code Detail

MEDICARE: DR. EDWIN OSCAR BYRD III M.D.

MEDICARE: DR. EDWIN OSCAR BYRD III M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician16703SC

General Provider Information

NPI Number : 1891775516
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWIN OSCAR BYRD III M.D.
Provider Business Mailing Address
First Line : PO BOX 159
Second Line :
City : REIDVILLE
State : SC
Zip : 29375-0159
Country : US
Telephone Number : 864-486-0760
Fax Number : 864-486-0761
Provider Business Practice Location Address
First Line : 7280C REIDVILLE ROAD
Second Line :
City : WOODRUFF
State : SC
Zip : 29388-1618
Country : US
Telephone Number : 864-486-0760
Fax Number : 864-486-0761
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2006
Last Update Date : 11/15/2007

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