Provider Demographics
NPI:1093846933
Name:MICHAEL D BIRNBAUM MD, PC
Entity Type:Organization
Organization Name:MICHAEL D BIRNBAUM MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REPRODUCTIVE ENDOCRINOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:BIRNBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-886-9116
Mailing Address - Street 1:8380 OLD YORK ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027
Mailing Address - Country:US
Mailing Address - Phone:215-886-9116
Mailing Address - Fax:215-887-7072
Practice Address - Street 1:8380 OLD YORK ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027
Practice Address - Country:US
Practice Address - Phone:215-886-9116
Practice Address - Fax:215-887-7072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD009626E207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB33350Medicare UPIN
PABI019396Medicare ID - Type Unspecified