MEDICARE: MR. RICHARD A BIRD M.S.

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	237600000X	Audiologist-Hearing Aid Fitter	A00050	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0935671	OTHER	OH	ANTHEM
2	05036	OTHER	OH	UNKNOWN

General Provider Information

NPI Number	:	1831196211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD A BIRD M.S.

Provider Business Mailing Address
First Line	:	2938 CANTERBURY RD
Second Line	:
City	:	WESTLAKE
State	:	OH
Zip	:	44145-4607
Country	:	US
Telephone Number	:	440-871-6217
Fax Number	:	440-842-1961

Provider Business Practice Location Address
First Line	:	7057 W 130TH ST
Second Line	:	SUITE 303
City	:	PARMA HEIGHTS
State	:	OH
Zip	:	44130-7841
Country	:	US
Telephone Number	:	440-842-6113
Fax Number	:	440-842-1961

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	07/08/2007

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Directions to “ MR. RICHARD A BIRD M.S.” Practice Location

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