Provider Demographics
NPI:1548290257
Name:BICH, KIRSTEN I (MD)
Entity type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:I
Last Name:BICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:KIRSTEN
Other - Middle Name:INGRID
Other - Last Name:BICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4212 GRAND AVE
Mailing Address - Street 2:ESSENTIA HEALTH WEST DULUTH CLINIC
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55807
Mailing Address - Country:US
Mailing Address - Phone:218-786-3500
Mailing Address - Fax:
Practice Address - Street 1:4212 GRAND AVE
Practice Address - Street 2:ESSENTIA HEALTH WEST DULUTH CLINIC
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55807
Practice Address - Country:US
Practice Address - Phone:218-786-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN39733207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1548290257Medicare PIN
MNG53380Medicare UPIN
MN080019497,Medicare PIN