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Individual
DR. MARK P BIRKENBACH
Active
Individual
DR. MARK P BIRKENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
0101224785
VA
207ZP0101X
Anatomic Pathology Physician
Primary
261QM1300X
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004910681
—
VA
01
—
008
CHAMPUS/TRICARE
VA
01
—
063MT
BC/BS NC
VA
01
—
283447
UHC/MAMSI/MDIPA
VA
01
—
28803
SENTARA OHP/SHP
VA
01
—
452114
BC/BS VA/HK
VA
01
—
57175
MINNESOTA MEDICAL LICENSE NUMBER
MN
05
—
89063MT
—
VA
01
—
PAR
FIRST HEALTH
VA
Enumeration date
02/03/2006
Last updated
12/19/2013
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