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General NPI Number Information
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NPI Number | 1932770823
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Entity Type | Organization
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Legal Business Name | EARLY BIRD SURGICAL LLC
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Dates
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Enumeration Date | 07/02/2021
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Last Update Date | 07/02/2021
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Provider Practice Location Address
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Address Line | 4002 RAPHUNE HILL RD STE 4
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City | ST THOMAS
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State | VI
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Zip | 00802-2903
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Country | US
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Telephone | 340-777-8918
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Fax |
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Provider Business Mailing Address
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Address Line | 4002 RAPHUNE HILL RD STE 4
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City | ST THOMAS
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State | VI
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Zip | 00802-2903
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Country | US
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Telephone | 340-777-8918
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. GLENDA WRENSFORD
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Credential | MD
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Telephone | 340-777-8918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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