Provider Demographics
NPI:1154328367
Name:BIRK, ANN C (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:C
Last Name:BIRK
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 1:8600 SPLIT OAK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-6934
Mailing Address - Country:US
Mailing Address - Phone:301-365-4447
Mailing Address - Fax:301-469-7263
Practice Address - Street 1:8600 SPLIT OAK CIRCLE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-6934
Practice Address - Country:US
Practice Address - Phone:301-365-4447
Practice Address - Fax:301-469-7263
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00144892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD221211100Medicaid
MD221211100Medicaid
DC490734Medicare PIN