Provider Demographics
NPI:1417198573
Name:BYRD, EDWARD BERNARD (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:BERNARD
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 1:2735 ROYAL TRACE LN
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-8124
Mailing Address - Country:US
Mailing Address - Phone:843-216-5444
Mailing Address - Fax:
Practice Address - Street 1:2735 ROYAL TRACE LN
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-8124
Practice Address - Country:US
Practice Address - Phone:843-216-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21659207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery