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General NPI Number Information
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NPI Number | 1912186818
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Entity Type | Organization
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Legal Business Name | K2 PHYSIATRY, PA
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 510 N ELAM AVE SUITE 302
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City | GREENSBORO
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State | NC
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Zip | 27403-1150
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Country | US
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Telephone | 336-297-2271
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Fax | 336-294-2282
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Provider Business Mailing Address
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Address Line | 510 N ELAM AVE SUITE 302
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City | GREENSBORO
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State | NC
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Zip | 27403-1150
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Country | US
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Telephone | 336-297-2271
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Fax | 336-294-2282
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW KIRSTEINS
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Credential | MD
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Telephone | 336-297-2271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 34651
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License Number State | NC
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