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Individual

DR. MICHAEL JOSEPH KIRWIN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
327 NORTH WASHINGTON AVE, STE 501, SCRANTON, PA 18503
(570) 342-8973
Mailing address
RR 1-116K, UNIONDALE, PA 18470
(570) 446-0927

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS009207L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001869307001
PENNA MEDICAL ASSISTANCE
PA
Enumeration date
02/14/2006
Last updated
07/08/2007
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