Individual
JOHN R KIRCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4175 N EUCLID AVE, SUITE 3, BAY CITY, MI 48706-2483
(989) 667-0491
(989) 667-0493
Mailing address
4175 N EUCLID AVE, SUITE 3, BAY CITY, MI 48706-2483
(989) 667-0491
(989) 667-0493
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601001075
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010Z960170
BLUE CROSS BLUE SHIELD PIN
MA
01
—
0P43930
GROUP PTAN
MI
01
—
0Z96017
MEDICARE GROUP PTAN
MI
01
—
JK001075
BLUE CROSS BLUE SHIELD LICENSE
MI
01
—
P43930007
INDIVIDUAL PTAN
MI
01
—
Z96017094
MEDICARE INDIVIDUAL PTAN
MI
Enumeration date
01/05/2007
Last updated
07/09/2008
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