Provider Demographics
NPI:1184699621
Name:BYRD, ERIC WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:WAYNE
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 1:735 6TH AVE W
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4168
Mailing Address - Country:US
Mailing Address - Phone:828-698-9193
Mailing Address - Fax:828-698-9155
Practice Address - Street 1:735 6TH AVE W
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4168
Practice Address - Country:US
Practice Address - Phone:828-698-9193
Practice Address - Fax:828-698-9155
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100126207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1082NOtherBCBS
NC1082NMedicaid
H40763Medicare UPIN
NC1082NMedicaid