Individual
DR. KEVIN MICHAEL FIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
121 NORTH WASHINGTON STREET, GRAND FORKS, ND 58203-3400
(701) 787-5862
(701) 738-2371
Mailing address
121 NORTH WASHINGTON STREET, GRAND FORKS, ND 58203-3400
(701) 787-5862
(701) 738-2371
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
441
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1G724FI
BCBS
MN
05
—
51100
—
ND
01
—
FIR19598
BCBS
ND
Enumeration date
09/06/2006
Last updated
10/16/2012
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