Provider Demographics
NPI:1740270420
Name:BIRCH, DONALD M (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:M
Last Name:BIRCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 W TIENKEN RD
Mailing Address - Street 2:STE 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:STE 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
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDB032540207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI382208290OtherCOMMERCIAL PROVIDER ID
MI1740270420OtherINDIVIDUAL NPI
MI1106305351OtherBCN
002545307OtherHIGHMARK BS PROVIDER NUMBER
MI0630535OtherBS PROVIDER NUMBER
MIB43435OtherHAP
MIDB032540OtherLICENSE NUMBER
MIMI3080OtherMEDICARE PTAN
01023109OtherHEALTH PLUS PROVIDER NUMBER
MI136845610Medicaid
MI1407161508OtherMEDICARE TYPE 2 NPI
MI4301032540OtherSTATE LICENSE
01023109OtherHEALTH PLUS PROVIDER NUMBER
MI382208290OtherCOMMERCIAL PROVIDER ID