Healthcare Provider Details

I. General information

NPI: 1912975244
Provider Name (Legal Business Name): KIMBERLY H BIRD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2006
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 JACKSON RIVER ROAD
MONTEREY VA
24465
US

IV. Provider business mailing address

PO BOX 490
MONTEREY VA
24465-0490
US

V. Phone/Fax

Practice location:
  • Phone: 540-468-3300
  • Fax: 540-468-3301
Mailing address:
  • Phone: 540-468-3300
  • Fax: 540-465-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101051608
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: