Provider Demographics
NPI:1770555955
Name:BIRMINGHAM, WILLIAM J (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:BIRMINGHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 STONEWALL RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2800
Mailing Address - Country:US
Mailing Address - Phone:704-639-1549
Mailing Address - Fax:
Practice Address - Street 1:120 STONEWALL RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2800
Practice Address - Country:US
Practice Address - Phone:704-639-1549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9401129174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7234797001OtherCIGNA PROVIDER NUMBER
NC4511801OtherAETNA PROVIDER NUMBER
NC020023755OtherRR MEDC PROVIDER NUMBER
NC9047OtherPARTNERS PROVIDER NUMBER
NC0925931OtherAETNA HMO PROVIDER NUMBER
NC1266115OtherUNITED PROVIDER NUMBER
NC15597OtherBCBS PROVIDER NUMBER
NC8915597Medicaid
NC2073917Other1ST HEALTH PROVIDER NUMBE
NC234218OtherPRIVATE HEALTH CARE SYS
NC901266OtherBEECHSTREET/FOCUS PROVIDE
NC262706OtherMAMSI PROVIDER NUMBER
NC53518OtherMEDCOST PROVIDER NUMBER
NCF88261Medicare UPIN
NC234218OtherPRIVATE HEALTH CARE SYS