Basic Information
| Provider Information | |||||||||
| NPI: | 1629401872 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BIRD | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | T | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD, MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10903 NEW HAMPSHIRE AVE | ||||||||
| Address2: | BLDG 22, RM 4133 | ||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209031058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105063869 | ||||||||
| FaxNumber: | 9999999999 | ||||||||
| Practice Location | |||||||||
| Address1: | 10903 NEW HAMPSHIRE AVE | ||||||||
| Address2: | BLDG 22, RM 4133 | ||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209031058 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105063869 | ||||||||
| FaxNumber: | 9999999999 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2013 | ||||||||
| LastUpdateDate: | 08/12/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PS 47337 | FL | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.