Provider Demographics
NPI:1891791315
Name:KIRSH, JAMES MALCOLM (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MALCOLM
Last Name:KIRSH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 LEIGHTON RD
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-2225
Mailing Address - Country:US
Mailing Address - Phone:207-878-9040
Mailing Address - Fax:207-878-9062
Practice Address - Street 1:66 LEIGHTON RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-2225
Practice Address - Country:US
Practice Address - Phone:207-878-9040
Practice Address - Fax:207-878-9062
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2010-01-11
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
ME1129207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1209000Medicaid
MEB58074Medicare UPIN