MEDICARE: JOHN BIRGIOLAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	4301104365	MI
2	207L00000X	Anesthesiology Physician	4301104365	MI
3	208VP0014X	Interventional Pain Medicine Physician	4301104365	MI

General Provider Information

NPI Number	:	1639309388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN BIRGIOLAS MD

Provider Business Mailing Address
First Line	:	431 SWARTZ CT STE 200
Second Line	:
City	:	IONIA
State	:	MI
Zip	:	48846-2161
Country	:	US
Telephone Number	:	616-841-2615
Fax Number	:	616-828-1752

Provider Business Practice Location Address
First Line	:	431 SWARTZ CT STE 200
Second Line	:
City	:	IONIA
State	:	MI
Zip	:	48846-2161
Country	:	US
Telephone Number	:	616-841-2615
Fax Number	:	616-828-1752

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2009
Last Update Date	:	03/05/2026

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Directions to “ JOHN BIRGIOLAS MD” Practice Location

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