1699781443 NPI number — DR. INGEBORG E KIRCH MD

Table of content: DR. INGEBORG E KIRCH MD (NPI 1699781443)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699781443 NPI number — DR. INGEBORG E KIRCH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KIRCH
Provider First Name:
INGEBORG
Provider Middle Name:
E
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699781443
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5649
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAGINAW
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48603-0649
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-797-2400
Provider Business Mailing Address Fax Number:
989-249-1035

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5161 CARDINAL PARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAGINAW
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48604-9435
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-797-2400
Provider Business Practice Location Address Fax Number:
989-249-1035
Provider Enumeration Date:
08/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  37088 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: 4301113672 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 042472266 . This is a "TRICARE CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7241458 . This is a "AETNA US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 69793 . This is a "HEALTHY START" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9317749 . This is a "CIGNA HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: J28266 . This is a "BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042472266 . This is a "THREE RIVERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0801554 . This is a "EVERCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 784039 . This is a "MVP HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2094514 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2098466 . This is a "MEDICAID WELFARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042472226 . This is a "PRIVATE HEALTHCARE SYSTEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2098466 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90546 . This is a "FALLON COMM HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042472266 . This is a "HEALTHCARE VALUE MGMNT" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA15528 . This is a "HARVARD PILGRIM HLTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042472266 . This is a "ONE HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 69793 . This is a "CHILDRENS MED SEC PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: A37828 . This is a "MEDICARE B" identifier . This identifiers is of the category "OTHER".




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