Bird, Mark Allen

Bird, Mark Allen is an individual health care provider with primary practice located at 159 Executive Dr Suite C, Danville VA 24541-4160. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Bird, Mark Allen can be contacted via phone (434) 792-5964.

Contact Information

Primary practice address
159 Executive Dr Suite C Danville VA 24541-4160
Phone: (434) 792-5964
Fax: (434) 792-5971
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 010123776 Virginia

Profile Details

NPI number 1710940325
LBN Legal business name Bird, Mark Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2006
Last updated Jan 10th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710940325 NPPES
Virginia MEDICAID 010151163
Virginia Other P00223399
Virginia Other 177390

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