Provider Demographics
NPI:1871535708
Name:BIRNBAUM, MICHAEL D (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:BIRNBAUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8380 OLD YORK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1539
Mailing Address - Country:US
Mailing Address - Phone:215-886-9116
Mailing Address - Fax:215-887-7072
Practice Address - Street 1:8380 OLD YORK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1539
Practice Address - Country:US
Practice Address - Phone:215-886-9116
Practice Address - Fax:215-887-7072
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2011-09-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD009626E207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA019396Medicare ID - Type Unspecified
PAB33350Medicare UPIN