Provider Demographics
NPI:1497729313
Name:BIRD, ZACHARY CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:CHARLES
Last Name:BIRD
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 1:10921 N. DALE MABRY
Mailing Address - Street 2:SHILOH MEDICAL CENTER
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618
Mailing Address - Country:US
Mailing Address - Phone:813-341-4000
Mailing Address - Fax:727-823-9502
Practice Address - Street 1:10921 N. DALE MABRY
Practice Address - Street 2:SHILOH MEDICAL CENTER
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618
Practice Address - Country:US
Practice Address - Phone:813-341-4000
Practice Address - Fax:813-341-4001
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME85344207L00000X
PA426252207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16270OtherBCBS
P00467503OtherRAILROAD MCR - BAYFRONT ANESTHESIA SERVICES
FL274487200Medicaid
FL16270OtherBCBS
FL274487200Medicaid