Birkenhagen, Walter Kurt

Birkenhagen, Walter Kurt is an individual health care provider with primary practice located at 500 S 11Th Ave , Pocatello ID 83201-4835. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Birkenhagen, Walter Kurt can be contacted via phone (208) 232-7434.

Contact Information

Primary practice address
500 S 11Th Ave Pocatello ID 83201-4835
Phone: (208) 232-7434
Fax: (208) 233-6446
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X M3705 Idaho

Profile Details

NPI number 1407849060
LBN Legal business name Birkenhagen, Walter Kurt
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2005
Last updated Mar 4th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407849060 NPPES
Idaho MEDICAID 002370100

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