Healthcare Provider Details

I. General information

NPI: 1699416586
Provider Name (Legal Business Name): CARSTEN MICHAEL KIRBY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 FAIRFAX AVE STE 445
NORFOLK VA
23507-1914
US

IV. Provider business mailing address

825 FAIRFAX AVE FL 5
NORFOLK VA
23507-1914
US

V. Phone/Fax

Practice location:
  • Phone: 757-446-8920
  • Fax:
Mailing address:
  • Phone: 757-446-8479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0102209298
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0102209298
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: