Provider Demographics
NPI:1386674018
Name:BIRD, FRANCES (MD)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:
Last Name:BIRD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 YORK RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-4437
Mailing Address - Country:US
Mailing Address - Phone:410-433-2200
Mailing Address - Fax:410-532-7246
Practice Address - Street 1:4340 PARK HEIGHTS AVE
Practice Address - Street 2:JAI MEDICAL CENTER
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-6725
Practice Address - Country:US
Practice Address - Phone:410-542-8130
Practice Address - Fax:410-542-1826
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0053683208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD211540002OtherJAI MEDICAL SYSTEM MCO
MD219300100Medicaid
MD6868280102OtherBLUECROSS/BLUESHIED MD
MD219300100Medicaid
MD211540002OtherJAI MEDICAL SYSTEM MCO