MEDICARE: WILLIAM J STARBIRD MD

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
1	207Q00000X	Family Medicine Physician	4301407209	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0D410160	OTHER	MI	MEDICARE GROUP NUMBER

General Provider Information

NPI Number	:	1629172069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM J STARBIRD MD

Provider Business Mailing Address
First Line	:	4000 HURON ST
Second Line	:
City	:	NORTH BRANCH
State	:	MI
Zip	:	48461-8664
Country	:	US
Telephone Number	:	810-688-3048
Fax Number	:	810-688-2640

Provider Business Practice Location Address
First Line	:	4000 HURON ST
Second Line	:
City	:	NORTH BRANCH
State	:	MI
Zip	:	48461-8664
Country	:	US
Telephone Number	:	810-688-3048
Fax Number	:	810-688-2640

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	03/04/2008

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Directions to “ WILLIAM J STARBIRD MD” Practice Location

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