Provider Demographics
NPI:1699756767
Name:BIRCH, CHRISTOPHER A
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:A
Last Name:BIRCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18TH MEDCOM
Mailing Address - Street 2:ATTN: DCCS - AM
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205-0054
Mailing Address - Country:KR
Mailing Address - Phone:011-822-7916
Mailing Address - Fax:011-822-7917
Practice Address - Street 1:18TH MEDCOM
Practice Address - Street 2:ATTN: DCCS - AM
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205-0054
Practice Address - Country:KR
Practice Address - Phone:011-822-7916
Practice Address - Fax:011-822-7917
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX199334164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse