Individual
JOHN BIRKNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
49 SPRING ST, SCARBOROUGH, ME 04074-8926
(207) 885-0011
Mailing address
49 SPRING ST, SCARBOROUGH, ME 04074-8926
(207) 885-0011
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
0101244138
VA
207T00000X
Neurological Surgery Physician
MD23462
ME
2086S0120X
Pediatric Surgery Physician
0101244138
VA
2086S0120X
Pediatric Surgery Physician
MD422479
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134329402
OPTIMA HEALTH CARE
VA
05
—
1134329402
—
VA
01
—
364137
ANTHEM BC/BS
VA
05
—
5910591
—
NC
Enumeration date
07/24/2007
Last updated
05/28/2020
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