Provider Demographics
NPI:1891775516
Name:BYRD, EDWIN OSCAR III (MD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:OSCAR
Last Name:BYRD
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:REIDVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29375-0159
Mailing Address - Country:US
Mailing Address - Phone:864-486-0760
Mailing Address - Fax:864-486-0761
Practice Address - Street 1:7280C REIDVILLE ROAD
Practice Address - Street 2:
Practice Address - City:WOODRUFF
Practice Address - State:SC
Practice Address - Zip Code:29388-1618
Practice Address - Country:US
Practice Address - Phone:864-486-0760
Practice Address - Fax:864-486-0761
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2007-11-15
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Provider Licenses
StateLicense IDTaxonomies
SC16703207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCF99307Medicare UPIN