Provider Demographics
NPI:1265500250
Name:KIRCHMAYER, DEANNA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:MARIE
Last Name:KIRCHMAYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 CAROLINA ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1303
Mailing Address - Country:US
Mailing Address - Phone:336-275-0751
Mailing Address - Fax:
Practice Address - Street 1:1201 CAROLINA ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1303
Practice Address - Country:US
Practice Address - Phone:336-275-0751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34650204C00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCBK2860092OtherDEA
NCBK2860092OtherDEA