| Dr Michael John Kirby, MD | |
|
445 N Fenway Dr, Fenton, MI 48430-2666 | |
| (810) 750-6060 | |
| (810) 750-6081 |
| Full Name | Dr Michael John Kirby |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 445 N Fenway Dr, Fenton, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760429450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 4301080170 (Michigan) | Primary |
| Entity Name | Michael J Kirby Md Plc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467747774 PECOS PAC ID: 4688844996 Enrollment ID: O20110824000356 |
| Entity Name | Genesys Pho Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275820110 PECOS PAC ID: 7618240409 Enrollment ID: O20180419001744 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael John Kirby, MD 445 N Fenway Dr, Fenton, MI 48430-2666 Ph: (810) 750-6060 | Dr Michael John Kirby, MD 445 N Fenway Dr, Fenton, MI 48430-2666 Ph: (810) 750-6060 |
Dr. Chandra K Puttagunta, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1122 N Leroy St, Fenton, MI 48430 Phone: 810-629-8303 Fax: 810-629-3949 | |
Rosemarie Kennedy, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2420 Owen Rd, Fenton, MI 48430 Phone: 810-496-2500 Fax: 810-629-0415 |