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General NPI Number Information
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NPI Number | 1417919861
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Entity Type | Organization
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Legal Business Name | DAVID BIRCH D.O.
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Dates
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Enumeration Date | 04/03/2006
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Last Update Date | 04/24/2009
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Provider Practice Location Address
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Address Line | 19160 COASTAL HWY UNIT A
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City | REHOBOTH BEACH
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State | DE
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Zip | 19971-6110
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Country | US
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Telephone | 302-644-0714
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Fax | 302-644-0716
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Provider Business Mailing Address
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Address Line | 1602 NEWPORT GAP PIKE
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City | WILMINGTON
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State | DE
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Zip | 19808-6208
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Country | US
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Telephone | 302-633-5740
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Fax | 302-633-5844
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID BIRCH
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Credential | D.O.
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Telephone | 302-644-0714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C20002893
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License Number State | DE
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