Individual
JUSTIN KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-7679
Mailing address
5211 DAYBROOK CIR APT 128, BALTIMORE, MD 21237-5050
(410) 931-1791
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0003109
MD
Other
Enumeration date
06/07/2006
Last updated
07/08/2007
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