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Individual

CAROL MARIE BIRT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2600 W 6TH ST, UNIT E-1, LAWRENCE, KS 66049-4318
(239) 247-1313
Mailing address
2600 W 6TH ST, UNIT E-1, LAWRENCE, KS 66049
(239) 247-1313

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME 88874
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0423511
PROFESSIONAL LICENSE
KS
Enumeration date
09/16/2006
Last updated
06/18/2013
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