Provider Demographics
NPI:1215090402
Name:DAMIAN E BIRCHESS MD ET AL PTR CHRISTINE L COMMERFORD MD
Entity type:Organization
Organization Name:DAMIAN E BIRCHESS MD ET AL PTR CHRISTINE L COMMERFORD MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMIAN
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:BIRCHESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-788-4800
Mailing Address - Street 1:5411 OLD FREDERICK RD
Mailing Address - Street 2:SUITE 18
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-2195
Mailing Address - Country:US
Mailing Address - Phone:410-788-4800
Mailing Address - Fax:410-788-6701
Practice Address - Street 1:5411 OLD FREDERICK RD
Practice Address - Street 2:SUITE 18
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-2195
Practice Address - Country:US
Practice Address - Phone:410-788-4800
Practice Address - Fax:410-788-6701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA731DEOtherBCBS
DCR828OtherBCBS
DCR828OtherBCBS
MDA731DEOtherBCBS