Provider Demographics
NPI:1346378205
Name:BIRENBAUM, GEORGES (MD)
Entity Type:Individual
Prefix:
First Name:GEORGES
Middle Name:
Last Name:BIRENBAUM
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 1:1001 DR MARTIN LUTHER KING JR AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4713
Mailing Address - Country:US
Mailing Address - Phone:505-247-1073
Mailing Address - Fax:505-247-2153
Practice Address - Street 1:1001 DR MARTIN LUTHER KING JR AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4713
Practice Address - Country:US
Practice Address - Phone:505-247-1073
Practice Address - Fax:505-247-2153
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM71-108207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology