Provider Demographics
NPI:1265411508
Name:BIRCH, DAVID ROBERT (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROBERT
Last Name:BIRCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:810 SEABURY AVENUE
Mailing Address - Street 2:BEEBE FAMILY PRACTICE - MILFORD
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963
Mailing Address - Country:US
Mailing Address - Phone:302-393-2056
Mailing Address - Fax:302-422-9359
Practice Address - Street 1:810 SEABURY AVENUE
Practice Address - Street 2:BEEBE FAMILY PRACTICE - MILFORD
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963
Practice Address - Country:US
Practice Address - Phone:302-393-2056
Practice Address - Fax:302-422-9359
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0002893207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE08D0206718OtherCLIA
DE0000132303Medicaid
DE080010983OtherPALMETTO GBA
DE0000132303Medicaid
DE089495Medicare PIN