Provider Demographics
NPI:1295757425
Name:KIRWAN, JANET M (MD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:M
Last Name:KIRWAN
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 1:50 TIMBER LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7204
Mailing Address - Country:US
Mailing Address - Phone:800-243-5854
Mailing Address - Fax:206-824-9510
Practice Address - Street 1:50 TIMBER LN
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7204
Practice Address - Country:US
Practice Address - Phone:800-243-5854
Practice Address - Fax:206-824-9510
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0010967174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN3789Medicaid
VTVN3789Medicare ID - Type Unspecified
VT0VN3789Medicaid