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General NPI Number Information
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NPI Number | 1376607671
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Entity Type | Individual
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Provider Name | ARETHUSA STEVENS KIRK MD
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Gender | Female
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 2401 LIBERTY HEIGHTS AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-8019
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Country | US
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Telephone | 410-383-8300
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Fax | 410-383-3160
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Provider Business Mailing Address
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Address Line | 2401 LIBERTY HEIGHTS AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-8019
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Country | US
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Telephone | 410-383-8300
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Fax | 410-383-3160
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | D0065614
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License Number State | MD
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