Healthcare Provider Details

I. General information

NPI: 1952746570
Provider Name (Legal Business Name): WHITNEY L KIRCHOFF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2013
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2706 MEDICAL OFFICE PL
GOLDSBORO NC
27534-9462
US

IV. Provider business mailing address

21 TOTMAN ST
QUINCY MA
02169-7564
US

V. Phone/Fax

Practice location:
  • Phone: 919-734-4736
  • Fax: 919-580-1017
Mailing address:
  • Phone: 617-745-0050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number273435
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number201902680
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: