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General NPI Number Information
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NPI Number | 1821194846
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Entity Type | Individual
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Provider Name | CAROL MARIE BIRT M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 06/18/2013
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Provider Practice Location Address
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Address Line | 2600 W 6TH ST UNIT E-1
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City | LAWRENCE
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State | KS
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Zip | 66049-4318
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Country | US
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Telephone | 239-247-1313
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 W 6TH ST, UNIT E-1
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City | LAWRENCE
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State | KS
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Zip | 66049
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Country | US
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Telephone | 239-247-1313
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME 88874
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License Number State | FL
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