Healthcare Provider Details

I. General information

NPI: 1932029352
Provider Name (Legal Business Name): DUWHAN J BIRD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20001 EUCLID AVE
EUCLID OH
44117-1480
US

IV. Provider business mailing address

6386 WOODHAWK DR
MAYFIELD HEIGHTS OH
44124-4153
US

V. Phone/Fax

Practice location:
  • Phone: 216-570-5665
  • Fax:
Mailing address:
  • Phone: 216-570-5665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberRS977151
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: