Provider Demographics
NPI:1033277090
Name:BYRD, SAMANTHA JOAN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:JOAN
Last Name:BYRD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:JOAN
Other - Last Name:CONNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:314 S SOUTH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-4491
Mailing Address - Country:US
Mailing Address - Phone:910-734-7252
Mailing Address - Fax:
Practice Address - Street 1:314 S SOUTH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-4491
Practice Address - Country:US
Practice Address - Phone:336-789-4300
Practice Address - Fax:336-786-2404
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00715363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant