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General NPI Number Information
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NPI Number | 1205199874
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Entity Type | Individual
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Provider Name | RICHARD BIRKETT M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/19/2012
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 100 CUMMINGS CTR STE 112D
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City | BEVERLY
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State | MA
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Zip | 01915-6105
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Country | US
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Telephone | 978-922-9226
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Fax | 410-706-6976
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Provider Business Mailing Address
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Address Line | 100 CUMMINGS CTR STE 112D
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City | BEVERLY
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State | MA
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Zip | 01915-6105
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Country | US
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Telephone | 978-922-9226
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Fax | 410-706-6976
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | D85611
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 252467
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | MT214631
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | 271766
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 271766
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License Number State | MA
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