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Individual

RICHARD A IRVIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2129 NATIONAL RD, WHEELING, WV 26003-5247
(304) 242-2303
(304) 242-4231
Mailing address
2129 NATIONAL RD, P.O. BOX 2079, WHEELING, WV 26003-5247
(304) 242-2303
(304) 242-4231

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1279
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001705854
BLUE CROSS/BLUE SHIELD/MT
WV
01
0053352001
PAAS
WV
05
0053352001
WV
01
0205733701
WV COMP
WV
01
1279C
HEALTH PLAN OF THE UPPER
WV
01
153563
CARELINK
WV
05
2310412
OH
Enumeration date
10/19/2005
Last updated
10/26/2007
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