Provider Demographics
NPI:1700037645
Name:BOYD, EDWARD ROYAL JR
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:ROYAL
Last Name:BOYD
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 S ALSTON AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-1517
Mailing Address - Country:US
Mailing Address - Phone:919-806-8700
Mailing Address - Fax:919-806-8733
Practice Address - Street 1:3417 S ALSTON AVE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-1517
Practice Address - Country:US
Practice Address - Phone:919-806-8700
Practice Address - Fax:919-806-8733
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator