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General NPI Number Information
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NPI Number | 1881658219
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Entity Type | Individual
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Provider Name | ERIC DAVID KIRSCH PA-C
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Gender | Male
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 07/15/2008
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Provider Practice Location Address
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Address Line | 5960 FAIRVIEW RD SUITE 400
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City | CHARLOTTE
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State | NC
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Zip | 28210-3102
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Country | US
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Telephone | 704-496-2760
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Fax | 888-477-0432
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Provider Business Mailing Address
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Address Line | 5960 FAIRVIEW RD SUITE 400
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City | CHARLOTTE
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State | NC
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Zip | 28210-3102
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Country | US
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Telephone | 704-496-2760
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Fax | 888-477-0432
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 103668
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License Number State | NC
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