Provider Demographics
NPI:1124029301
Name:BIRKMEYER, LYNNE M (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:M
Last Name:BIRKMEYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4022 ZUCK RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-4592
Mailing Address - Country:US
Mailing Address - Phone:814-877-5424
Mailing Address - Fax:814-877-5423
Practice Address - Street 1:1202 STATE ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1914
Practice Address - Country:US
Practice Address - Phone:814-454-4530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT034397208000000X
VA034397208000000X
PAMD442035208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
0R4432OtherHEALTHNET
PA1025727420001Medicaid
HAP143OtherOXFORD
2602753OtherGHI
01034397OtherCIGNA
1528733OtherUNITED HEALTHCARE
343970OtherCONNECTICARE
CT010034397CT03OtherBLUECROSS/BLUE SHIELD
2396621OtherAETNA
CT001343970Medicaid
265500OtherMVP
1528733OtherUNITED HEALTHCARE
HAP143OtherOXFORD
01034397OtherCIGNA