MEDICARE: DR. CHRISTOPHER SOTHORON BYRD MD

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
1	207Q00000X	Family Medicine Physician	200200501	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	80188600	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	177872	OTHER	NC	WELL PATH
3	8743552	OTHER	NC	CIGNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	132GN	OTHER	NC	BLUE CROSS BLUE SHIELD
6	2234493	OTHER	NC	UNITED HEALTH CARE

General Provider Information

NPI Number	:	1619074804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER SOTHORON BYRD MD

Provider Business Mailing Address
First Line	:	2000 PERIMETER PARK DR STE 200
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-8442
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	781 AVENT FERRY RD
Second Line	:	SUITE 206
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-7776
Country	:	US
Telephone Number	:	919-552-8914
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	05/06/2021

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