Individual
LEAH REBECCA BYRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
146 E HOSPITAL DR STE 550, WEST COLUMBIA, SC 29169-4843
(803) 936-7410
(803) 936-7412
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1826
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336497874
—
SC
Enumeration date
08/15/2012
Last updated
10/15/2020
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