Provider Demographics
NPI:1831196211
Name:BIRD, RICHARD A (MS)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:A
Last Name:BIRD
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2938 CANTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-4607
Mailing Address - Country:US
Mailing Address - Phone:440-871-6217
Mailing Address - Fax:440-842-1961
Practice Address - Street 1:7057 W 130TH ST
Practice Address - Street 2:SUITE 303
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-7841
Practice Address - Country:US
Practice Address - Phone:440-842-6113
Practice Address - Fax:440-842-1961
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00050237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0935671OtherANTHEM
OH05036OtherUNKNOWN
OHBI0404851Medicare ID - Type UnspecifiedAUDIOLOGY ID FOR MEDICARE