Basic Information
| Provider Information | |||||||||
| NPI: | 1730177692 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BIRNS, GLOGER AND WITTEN, MD PC | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 9711 MEDICAL CENTER DR | ||||||||
| Address2: | SUITE 308 | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208503323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012511244 | ||||||||
| FaxNumber: | 3013409360 | ||||||||
| Practice Location | |||||||||
| Address1: | 9711 MEDICAL CENTER DR | ||||||||
| Address2: | SUITE 308 | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208503323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3012510015 | ||||||||
| FaxNumber: | 3013409360 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2005 | ||||||||
| LastUpdateDate: | 10/15/2008 | ||||||||
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| AuthorizedOfficialLastName: | BIRNS | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3012510015 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | D0024994 | MD | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.