Individual
ANTHONY J KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM PC
Contact information
Practice address
2050 BRETON RD SE, SUITE 105, GRAND RAPIDS, MI 49546-5547
(616) 949-1524
(616) 949-9472
Mailing address
2050 BRETON RD SE, SUITE 105, GRAND RAPIDS, MI 49546-5547
(616) 949-1524
(616) 949-9472
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
AK400050
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4355335
—
MI
01
—
4854111170
BCBS
—
Enumeration date
08/30/2006
Last updated
04/08/2008
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