Healthcare Provider Details

I. General information

NPI: 1922326123
Provider Name (Legal Business Name): AARON BIRCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date: 06/25/2021
Reactivation Date: 07/15/2021

III. Provider practice location address

MADIGAN ARMY MEDICAL CENTER 9040A JACKSON AVE
TACOMA WA
98431-0001
US

IV. Provider business mailing address

MADIGAN ARMY MEDICAL CENTER 9040A JACKSON AVE
TACOMA WA
98431-0001
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-1390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberC173082
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberC173082
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: