Individual
DR. CARL R WIRTH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
90 CARSTEAD DR, SLINGERLANDS, NY 12159-9793
(518) 439-9417
Mailing address
90 CARSTEAD DR, SLINGERLANDS, NY 12159-9793
(518) 439-9417
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
099341
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
099341
NEW YORK STATE LICENSE
NY
Enumeration date
06/16/2006
Last updated
07/08/2007
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