Provider Demographics
NPI:1790760072
Name:BIRCHER, NORMAN NOWAK (PAC)
Entity Type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:NOWAK
Last Name:BIRCHER
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5461 NURSERY RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17315-2335
Mailing Address - Country:US
Mailing Address - Phone:717-292-9720
Mailing Address - Fax:
Practice Address - Street 1:2480 LLEWELLYN AVE
Practice Address - Street 2:ATTN: MCXR-CR . KIMBROUGH AMBULATORY CARE CENTER
Practice Address - City:FT MEADE
Practice Address - State:MD
Practice Address - Zip Code:20755-5800
Practice Address - Country:US
Practice Address - Phone:301-677-8270
Practice Address - Fax:301-677-8176
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA002196L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical