Provider Demographics
NPI:1770567224
Name:BIRDWELL, JOSEPH M (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:BIRDWELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5920
Mailing Address - Country:US
Mailing Address - Phone:410-234-1600
Mailing Address - Fax:410-727-4148
Practice Address - Street 1:3 NASHUA CT
Practice Address - Street 2:SUITE H
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21221-3133
Practice Address - Country:US
Practice Address - Phone:410-933-5678
Practice Address - Fax:410-933-4835
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1534026OtherCAQH
MD542355OtherCAREFIRST
MD542355OtherCAREFIRST
MD1534026OtherCAQH