Healthcare Provider Details

I. General information

NPI: 1093940181
Provider Name (Legal Business Name): KIRK M VOLKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2009
Last Update Date: 09/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1165 IMPERIAL DR SUITE 200
HAGERSTOWN MD
21740-6555
US

IV. Provider business mailing address

63 THOMAS JOHNSON DR STE A
FREDERICK MD
21702-4389
US

V. Phone/Fax

Practice location:
  • Phone: 443-351-3376
  • Fax: 410-384-7259
Mailing address:
  • Phone: 410-351-3376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberD0076177
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberD0076177
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: