Individual
MARSHALL DEWAYNE BYRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502
Mailing address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
77647
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
037997
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558375048
TRICARE
NC
05
—
8050615
—
NC
01
—
P00601245
RAILROAD MEDICARE
NC
Enumeration date
07/28/2006
Last updated
03/30/2021
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