Gary Birnbaum, M.D.

Individual provider Active NPI Neurology Physician · Golden Valley, MN

NPI 1902850159 · NPPES record last updated Jul 11, 2007

Key facts

NPI
1902850159
Entity type
Individual (NPI type 1)
Primary specialty
Neurology Physician 2084N0400X
License
23916 (MN)
Practice address
4225 Golden Valley Rd
Golden Valley, MN 55422-4215
Phone
(763) 588-0661
Fax
(763) 287-2310
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23916MNMDNeurology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 23916 MN Yes

Addresses

Primary practice location

4225 Golden Valley Rd
Golden Valley, MN 55422-4215

Mailing address

4225 Golden Valley Rd
Golden Valley, MN 55422-4215
Phone (763) 588-0661

Other identifiers

IdentifierTypeStateIssuer
HP21939OtherMNHEALTHPARTNERS
0507277OtherMNMEDICA
1008983OtherMNPREFERRED ONE
765068OtherMNAMERICA'S PPO
30228900MedicaidWI
36B41BIOtherMNBCBS OF MN

Other providers in Golden Valley, MN

All providers in Golden Valley, MN · Neurology Physician in Minnesota

Sources for this page

Verify at the official NPI Registry.