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General NPI Number Information
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NPI Number | 1053379156
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Entity Type | Individual
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Provider Name | STEPHEN MITCHELL KIRKLAND M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 06/23/2009
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Provider Practice Location Address
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Address Line | 3073 TRENWEST DR
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City | WINSTON-SALEM
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State | NC
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Zip | 27103-3207
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Country | US
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Telephone | 336-768-0437
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Fax | 336-768-0433
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Provider Business Mailing Address
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Address Line | 1701 WESTCHESTER DRIVE SUITE 850
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City | HIGH POINT
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State | NC
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Zip | 27262-7254
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Country | US
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Telephone | 336-802-2400
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Fax | 336-802-2001
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 30052
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License Number State | NC
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