# JOHN RICHARD IREDALE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1477549160
- **Gender:** Man
- **Credential:** D.P.M.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 51 | NC | Yes |

## Other

- **Enumeration date:** 09/27/2005
- **Last updated:** 05/04/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 08092 | BCBS OF NC PROVIDER NUMBE | NC |
| 05 | — | 8908092 | — | NC |