Provider Demographics
NPI:1871573162
Name:KIRSCHSTEIN, MATTHEW PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:PAUL
Last Name:KIRSCHSTEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:SLEEPY EYE
Mailing Address - State:MN
Mailing Address - Zip Code:56085-1316
Mailing Address - Country:US
Mailing Address - Phone:507-794-4971
Mailing Address - Fax:507-794-4971
Practice Address - Street 1:201 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:SLEEPY EYE
Practice Address - State:MN
Practice Address - Zip Code:56085-1316
Practice Address - Country:US
Practice Address - Phone:507-794-4971
Practice Address - Fax:507-794-4971
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN61293OtherMINNESOTA PHY. ID. NUMBER
MN611828300Medicaid
MN359000651Medicare ID - Type Unspecified
MNT65711Medicare UPIN