Individual
DR. KIMBERLY A BIRCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1108 CENTRAL AVENUE, MORIARTY, NM 87035
(505) 832-4434
(505) 832-5024
Mailing address
12127B HWY 14 N STE 5, CEDAR CREST, NM 87008-9461
(505) 832-4434
(505) 832-5024
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-115172
IL
207R00000X
Internal Medicine Physician
Primary
A-1608-11
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036115172
—
IL
Enumeration date
03/23/2006
Last updated
04/05/2012
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