Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 35-063087 | OH |
NPI | 1164465035 |
---|---|
Provider Name | Dr. Michael W. Bird |
First Address | Akron, OH 44308-1063 |
Second Address | Akron, OH 44308-1063 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 11/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0879125 | (05) | OH |
E95022 | (02) |