Provider Demographics
NPI:1073614475
Name:BYRD, MILTON DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:MILTON
Middle Name:DANIEL
Last Name:BYRD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 BOULEVARD NE
Mailing Address - Street 2:SUITE 414
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312
Mailing Address - Country:US
Mailing Address - Phone:404-577-1231
Mailing Address - Fax:404-215-9061
Practice Address - Street 1:340 BOULEVARD NE
Practice Address - Street 2:SUITE 414
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312
Practice Address - Country:US
Practice Address - Phone:404-577-1231
Practice Address - Fax:404-215-9061
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA10494207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00079582DMedicaid
E01487Medicare UPIN
GA00079582DMedicaid