Individual
DR. JOHN D IRVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4654 LONG BEACH RD SE, SOUTHPORT, NC 28461-8799
(910) 457-9564
(910) 457-6744
Mailing address
6407 GREEN ARBOR LN, WILMINGTON, NC 28409-2137
(910) 470-3888
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
94-01419
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0128762
UNITED HEALTHCARE
NC
01
—
145G6
BCBS OF NC
NC
01
—
77610
MEDCOST
NC
05
—
8945429
—
NC
Enumeration date
09/29/2005
Last updated
03/04/2014
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