Doctor Name: | MR. NORMAN NOWAK BIRCHER |
NPI Number: | 1790760072 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PAC |
License Number: | MA002196L |
Business Practice Address: | 2480 Llewellyn Ave Attn: Mcxr-cr . Kimbrough Ambulatory Care Center Ft Meade, MD - 207555800 |
Business Phone Number: | 3016778270 |
Business Fax Number: | 3016778176 |
Mailing Address: | 5461 Nursery Rd, DOVER |
State: | PA |
Postal Code: | 173152335 |
Phone Number: | 7172929720 |
Fax Number: | |
NPI Enumeration Date: | 12/09/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | MA002196L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |