Provider Demographics
NPI:1023046190
Name:BIRDI, AMARJEET S (MD)
Entity Type:Individual
Prefix:DR
First Name:AMARJEET
Middle Name:S
Last Name:BIRDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10343 YELLOW LOCUST LN
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-9470
Mailing Address - Country:US
Mailing Address - Phone:937-602-1861
Mailing Address - Fax:
Practice Address - Street 1:627 S EDWIN C MOSES BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3461
Practice Address - Country:US
Practice Address - Phone:937-424-1000
Practice Address - Fax:937-424-1002
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350727442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PO1068642OtherMEDICARE RAIL ROAD
OH2031269Medicaid
H125600OtherMEDICARE PTAN
OH2031269Medicaid