Individual
EVGENY KIRSANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
140 ACADEMY ST, PRESQUE ISLE, ME 04769-3102
(207) 768-4000
Mailing address
140 ACADEMY ST, PRESQUE ISLE, ME 04769-3102
(207) 768-4000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD19390
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053549295
—
ME
Enumeration date
06/25/2009
Last updated
11/04/2013
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