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Dr. Peter Birk
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NPI Number Detailed Information
Provider Information:
| Name: | Dr. Peter Birk |
| Gender: | M |
| Provider License Number If Given: | 101029919 |
NPI Information:
| NPI: | 1962401406 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/18/2005 |
| Last Update Date: | 3/13/2014 |
Provider Business Mailing Address:
| Address: | 1821 OLD DONATION PKWY SUITE 11 Virginia Beach, VA 23454 |
| Phone Number: | 7574812669 |
| Fax Number: | 7574814967 |
Provider Business Practice Location Address:
| Address: | 1821 OLD DONATION PKWY SUITE 11 Virginia Beach, VA 23454 |
| Phone Number: | 7574812669 |
| Fax Number: | 7574814967 |
Provider Taxonomy:
| Primary: | 174400000X |
| Secondary (if any): | |
| State: | VA |
