Provider Demographics
NPI:1447237482
Name:BYRAM, MELODY FLOYD (DO)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:FLOYD
Last Name:BYRAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1523 22ND AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-4016
Mailing Address - Country:US
Mailing Address - Phone:601-703-8370
Mailing Address - Fax:855-320-7336
Practice Address - Street 1:657 TROJAN PKWY
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36079-0002
Practice Address - Country:US
Practice Address - Phone:334-934-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3137208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00120729Medicaid
H05204Medicare UPIN