Individual
JEREMY MICHAEL BYRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28058
SC
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
28058
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
280582
—
SC
01
—
P00801532
RR MEDICARE
SC
Enumeration date
09/22/2006
Last updated
10/20/2022
Update your record
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