Provider Demographics
NPI:1457351462
Name:BYRD, TERRI M (MD)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:M
Last Name:BYRD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 CORNERSTONE CT
Mailing Address - Street 2:
Mailing Address - City:MC CAYSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30555-1789
Mailing Address - Country:US
Mailing Address - Phone:910-489-2921
Mailing Address - Fax:
Practice Address - Street 1:3170 WAYAH RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-8120
Practice Address - Country:US
Practice Address - Phone:910-489-2921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200401177207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00319497OtherRAILROAD MEDICARE
P00319497OtherRAILROAD MEDICARE
NC2041096AMedicare PIN
NCD16774Medicare UPIN