Provider Demographics
NPI:1316902950
Name:MARSH, BYRON PATTERSON (MD)
Entity type:Individual
Prefix:DR
First Name:BYRON
Middle Name:PATTERSON
Last Name:MARSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BYRON
Other - Middle Name:P
Other - Last Name:MARSH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 919
Mailing Address - Street 2:
Mailing Address - City:PICKENS
Mailing Address - State:SC
Mailing Address - Zip Code:29671-0919
Mailing Address - Country:US
Mailing Address - Phone:864-878-1231
Mailing Address - Fax:864-878-6656
Practice Address - Street 1:123 W.G. ACKER DRIVE
Practice Address - Street 2:SUITE C
Practice Address - City:PICKENS
Practice Address - State:SC
Practice Address - Zip Code:29671-2739
Practice Address - Country:US
Practice Address - Phone:864-878-1231
Practice Address - Fax:864-878-6656
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18342207X00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP1399Medicaid
SCGP5062Medicaid
SCGP5062Medicaid
5664Medicare PIN
SCGP1399Medicaid