Provider Demographics
NPI:1396707592
Name:VURLICER, KIRA LEITH (MD)
Entity type:Individual
Prefix:DR
First Name:KIRA
Middle Name:LEITH
Last Name:VURLICER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KIRA
Other - Middle Name:LEITH
Other - Last Name:VURLICER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:213 BARDEN ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NC
Mailing Address - Zip Code:27569-7206
Mailing Address - Country:US
Mailing Address - Phone:919-936-5171
Mailing Address - Fax:919-936-2328
Practice Address - Street 1:213 BARDEN ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NC
Practice Address - Zip Code:27569-7206
Practice Address - Country:US
Practice Address - Phone:919-936-5171
Practice Address - Fax:919-936-2328
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200401445207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5904198Medicaid
NC2036641Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
NC5904198Medicaid