MEDICARE: DR. DONALD M BIRCH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	DB032540	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	MI3080	OTHER	MI	MEDICARE PTAN
11	1407161508	OTHER	MI	MEDICARE TYPE 2 NPI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	382208290	OTHER	MI	COMMERCIAL PROVIDER ID
2	1740270420	OTHER	MI	INDIVIDUAL NPI
3	1106305351	OTHER	MI	BCN
4	002545307	OTHER		HIGHMARK BS PROVIDER NUMBER
5	0630535	OTHER	MI	BS PROVIDER NUMBER
6	B43435	OTHER	MI	HAP
7	DB032540	OTHER	MI	LICENSE NUMBER
9	01023109	OTHER		HEALTH PLUS PROVIDER NUMBER
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	4301032540	OTHER	MI	STATE LICENSE

General Provider Information

NPI Number	:	1740270420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD M BIRCH M.D.

Provider Business Mailing Address
First Line	:	330 W TIENKEN RD
Second Line	:	STE C
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48306-4474
Country	:	US
Telephone Number	:	248-651-2640
Fax Number	:	248-651-2543

Provider Business Practice Location Address
First Line	:	330 W TIENKEN RD
Second Line	:	STE C
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48306-4474
Country	:	US
Telephone Number	:	248-651-2640
Fax Number	:	248-651-2543

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	04/05/2012

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