Provider Demographics
NPI:1033108733
Name:BIRD, WILLIAM CLAUDE (MD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CLAUDE
Last Name:BIRD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3997 BECKLEY RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740
Mailing Address - Country:US
Mailing Address - Phone:304-431-5499
Mailing Address - Fax:304-431-3400
Practice Address - Street 1:3997 BECKLEY RD
Practice Address - Street 2:BLUESTONE HEALTH ASSOC
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740
Practice Address - Country:US
Practice Address - Phone:304-431-5499
Practice Address - Fax:304-431-3400
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV13911207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001706661OtherBCBS
WV0035334000Medicaid
WV0051867000Medicaid
WV001719931OtherBCBS
WVCD7656OtherRR MC
WVA72343Medicare UPIN
WV0035334000Medicaid
WV001706661OtherBCBS
WV5118601Medicare Oscar/Certification
WVBI0778261Medicare PIN
WV511860Medicare Oscar/Certification