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Individual

CAROLYN WILSON BIRD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD, MPH

Contact information

Practice address
1200 N TELEGRAPH RD, PONTIAC, MI 48341-0432
(248) 858-1276
(248) 858-5639
Mailing address
1200 N TELEGRAPH RD, PONTIAC, MI 48341-1032
(248) 858-1276
(248) 858-5639

Taxonomy

Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
4301030690
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0F37045
BCBSM
MI
05
1811218
MI
05
2700670
MI
Enumeration date
10/18/2006
Last updated
07/09/2007
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