Basic Information
Provider Information
NPI: 1891811543
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BIRMINGHAM
FirstName: JAMES
MiddleName: DOUGLAS
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5900 BYRON CENTER AVE SW
Address2:  
City: WYOMING
State: MI
PostalCode: 495199606
CountryCode: US
TelephoneNumber: 6162523243
FaxNumber: 6162520260
Practice Location
Address1: 5900 BYRON CENTER AVE SW
Address2:  
City: WYOMING
State: MI
PostalCode: 49519
CountryCode: US
TelephoneNumber: 1625252026
FaxNumber: 6162525261
Other Information
ProviderEnumerationDate: 03/22/2007
LastUpdateDate: 02/13/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RR0500X4301072323MIY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

No ID Information.


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