Healthcare Provider Details

I. General information

NPI: 1710204144
Provider Name (Legal Business Name): MICHAEL ERIC BIRNS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2010
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 ROUTE 70 STE 100A
MEDFORD NJ
08055-9501
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 609-267-9400
  • Fax: 609-451-5518
Mailing address:
  • Phone: 609-267-9400
  • Fax: 609-424-3517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA12726800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberMD459165
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: