Healthcare Provider Details

I. General information

NPI: 1427493568
Provider Name (Legal Business Name): SUSAN KIRSCH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 BUFORD HWY NE STE 540
BROOKHAVEN GA
30329-2143
US

IV. Provider business mailing address

2801 BUFORD HWY NE STE 540
BROOKHAVEN GA
30329-2143
US

V. Phone/Fax

Practice location:
  • Phone: 404-383-1099
  • Fax: 404-383-1099
Mailing address:
  • Phone: 404-383-1099
  • Fax: 404-383-1099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number71252
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number071252
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: