Healthcare Provider Details

I. General information

NPI: 1740270420
Provider Name (Legal Business Name): DONALD M BIRCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 04/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 W TIENKEN RD STE C
ROCHESTER HILLS MI
48306-4474
US

IV. Provider business mailing address

330 W TIENKEN RD STE C
ROCHESTER HILLS MI
48306-4474
US

V. Phone/Fax

Practice location:
  • Phone: 248-651-2640
  • Fax: 248-651-2543
Mailing address:
  • Phone: 248-651-2640
  • Fax: 248-651-2543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberDB032540
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: