Individual
GEOFFREY L BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-1858
(215) 590-1415
Mailing address
3401 CIVIC CENTER BLVD STE 9329, PHILADELPHIA, PA 19104-4319
(267) 425-9300
(267) 425-9331
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD059753L
PA
2080P0202X
Pediatric Cardiology Physician
MD059753L
PA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD059753L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001678010
—
PA
01
—
183100EMD
MEDICARE PTAN
PA
05
—
7527004
—
NJ
Enumeration date
07/25/2006
Last updated
06/01/2023
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