Individual
DANIEL JEFFREY KIRSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 713-4580
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
(336) 713-4580
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
200200559
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131FT
BCBS
NC
05
—
2005965000
—
WV
01
—
49043
PARTNERS
NC
05
—
6737161
—
VA
01
—
7494649
AETNA
—
05
—
89131FT
—
NC
01
—
B7060
MEDCOST
NC
05
—
Q0055G
—
SC
Enumeration date
11/30/2005
Last updated
11/15/2010
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