Provider Demographics
NPI:1194042747
Name:GEORGE, KIRSTEN CAROL (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:CAROL
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1903 W 8TH ST # 177
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-4936
Mailing Address - Country:US
Mailing Address - Phone:814-325-9409
Mailing Address - Fax:
Practice Address - Street 1:2808 STATE ST STE 102
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-1830
Practice Address - Country:US
Practice Address - Phone:814-325-9409
Practice Address - Fax:814-325-9805
Is Sole Proprietor?:No
Enumeration Date:2010-04-22
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT196705207R00000X
MDD00794652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine