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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

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