Individual
DR. JOHN BIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
263 FARMINGTON AVE, GASTROENTEROLOGY ASSOCIATES, FARMINGTON, CT 06030-0001
(860) 679-3238
(860) 679-1217
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
046228
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609801547
—
CT
Enumeration date
07/11/2006
Last updated
09/28/2022
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