Provider Demographics
NPI:1710133475
Name:BYRD, MAURICE SYNTEL
Entity Type:Individual
Prefix:MR
First Name:MAURICE
Middle Name:SYNTEL
Last Name:BYRD
Suffix:
Gender:M
Credentials:
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:J
Other - Last Name:WALLACE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:125 PARK OF COMMERCE DR
Mailing Address - Street 2:STE 200
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-7439
Mailing Address - Country:US
Mailing Address - Phone:912-238-8555
Mailing Address - Fax:
Practice Address - Street 1:4395 OGEECHEE RD
Practice Address - Street 2:STE 209
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-1249
Practice Address - Country:US
Practice Address - Phone:912-655-5423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
No171W00000XOther Service ProvidersContractor
No224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist