Individual
PHYLLIS BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
505 OLD WESTMINSTER PIKE, WESTMINSTER, MD 21157-6279
(410) 871-2990
(410) 871-2990
Mailing address
505 OLD WESTMINSTER PIKE, WESTMINSTER, MD 21157-6279
(410) 871-2990
(410) 871-2990
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
02568
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02568
LICENSE
MD
Enumeration date
02/07/2012
Last updated
03/29/2012
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