Provider Demographics
NPI:1295877660
Name:KIRSCH, DAVID ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:KIRSCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1173 S ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-7101
Mailing Address - Country:US
Mailing Address - Phone:248-644-9495
Mailing Address - Fax:
Practice Address - Street 1:1173 S ADAMS RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-7101
Practice Address - Country:US
Practice Address - Phone:248-644-9495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004268111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950F35086OtherBCBS PROVIDER NUMBER
MIP79697OtherBLUE CARE NET.PROV.#
MI16340OtherMCARE PROVIDER NUMBER
MI649802OtherACN PROVIDER NUMBER
MI0F35086Medicare ID - Type Unspecified
MI16340OtherMCARE PROVIDER NUMBER