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NPI Code Detail

MEDICARE: MATTHEW BIRD DO

MEDICARE: MATTHEW BIRD DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMRO-2136ID
2208M00000XHospitalist Physician14283975-1204UT

General Provider Information

NPI Number : 1629728282
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW BIRD DO
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 W FORT ST # 111R
Second Line :
City : BOISE
State : ID
Zip : 83702-4501
Country : US
Telephone Number : 208-422-1314
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2022
Last Update Date : 06/02/2026

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Directions to “ MATTHEW BIRD DO” Practice Location

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