Individual
DR. CHRISTIAN L BIRKEDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 MEMORIAL MEDICAL PKWY, SUITE 205, DAYTONA BEACH, FL 32117-5168
(386) 231-3530
(386) 231-3534
Mailing address
305 MEMORIAL MEDICAL PKWY, SUITE 205, DAYTONA BEACH, FL 32117-5168
(386) 231-3530
(386) 231-3534
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME84422
FL
2086S0129X
Vascular Surgery Physician
ME84422
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263857600
—
FL
Enumeration date
09/13/2005
Last updated
08/10/2012
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