Provider Demographics
NPI:1407161508
Name:DONALD M BIRCH MD PC
Entity Type:Organization
Organization Name:DONALD M BIRCH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:M
Authorized Official - Last Name:BIRCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-651-2640
Mailing Address - Street 1:330 W TIENKEN RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-4474
Mailing Address - Country:US
Mailing Address - Phone:248-651-2640
Mailing Address - Fax:248-651-2543
Practice Address - Street 1:330 W TIENKEN RD
Practice Address - Street 2:SUITE C
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48306-4474
Practice Address - Country:US
Practice Address - Phone:248-651-2640
Practice Address - Fax:248-651-2543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0630535OtherBS PROVIDER NUMBER
MI136845610Medicaid
MIDB032540OtherLICENSE NUMBER
MIDB032540OtherLICENSE NUMBER
MI0633150Medicare PIN