Provider Demographics
NPI:1346216306
Name:BIRDSONG, CLAIRE L (MD)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:L
Last Name:BIRDSONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:803-296-3307
Practice Address - Street 1:100 PALMETTO HEALTH PKWY STE 220
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-1755
Practice Address - Country:US
Practice Address - Phone:803-907-7700
Practice Address - Fax:803-907-7709
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC16116207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC161167Medicaid
SCF391455772Medicare PIN
SCF39145Medicare UPIN
SCSC0473C126Medicare PIN