Provider Demographics
NPI:1851381537
Name:BIRKS, CAROLINE (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:BIRKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-6610
Mailing Address - Fax:617-724-6649
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:BULFINCH MEDICAL GROUP, WANG 535
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-724-6610
Practice Address - Fax:617-724-6649
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213969207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA410043OtherTUFTS HEALTH PLAN
MA0198960Medicaid
MAJ24975OtherBCBS MA
H62652Medicare UPIN
MA0198960Medicaid