Healthcare Provider Details

I. General information

NPI: 1871592493
Provider Name (Legal Business Name): BRIAN M KIRSH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 K ST NW STE 500
WASHINGTON DC
20006-1003
US

IV. Provider business mailing address

3700 PARK EAST DR SUITE 100
BEACHWOOD OH
44122-4339
US

V. Phone/Fax

Practice location:
  • Phone: 240-737-0085
  • Fax: 202-296-0301
Mailing address:
  • Phone: 216-593-7700
  • Fax: 216-593-7190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD049110
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberD0091413
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: