Provider Demographics
NPI:1689874711
Name:BIRKU, YOSEPH A (MD)
Entity Type:Individual
Prefix:DR
First Name:YOSEPH
Middle Name:A
Last Name:BIRKU
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 1:2790 GODWIN BLVD STE 225
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-8155
Mailing Address - Country:US
Mailing Address - Phone:757-934-4550
Mailing Address - Fax:757-934-4109
Practice Address - Street 1:2790 GODWIN BLVD STE 225
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8155
Practice Address - Country:US
Practice Address - Phone:757-934-4550
Practice Address - Fax:757-934-4109
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT047962207R00000X
WI50079-020207R00000X
WAMD60254430207RI0200X
VA0101260626207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIFB0272752OtherDEA REGISTRATION