Individual
GLENN EDGAR IRWIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 CHESTNUT STREET EXT STE A, BRADFORD, PA 16701
(814) 817-2870
(814) 368-8041
Mailing address
900 CHESTNUT STREET EXT STE A, BRADFORD, PA 16701-2298
(814) 817-2870
(814) 368-8041
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
MD028763E
PA
207QA0505X
Adult Medicine Physician
Primary
MD028763E
PA
208D00000X
General Practice Physician
MD028763E
PA
Other
Enumeration date
01/04/2006
Last updated
01/31/2019
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