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Individual

DR. DAVID RUSSELL KIRLIN I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
251 WILMOT DR, GASTONIA, NC 28054-4048
(704) 861-0425
(704) 861-0274
Mailing address
251 WILMOT DR, GASTONIA, NC 28054-4048
(704) 861-0425
(704) 861-0274

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
168
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08114
BCBS
01
1031002
CIGNA
01
1031002005
CIGNA
01
10343
PARTNERS
01
107026
WELLNESS
01
17606
WELLPATH
01
238687
MAMSI
01
4406434
AETNA
01
561552247001
PRUDENTIAL
01
662897
AETNA
05
8908114
NC
05
PDN168
SC
Enumeration date
09/12/2005
Last updated
10/04/2011
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