Individual
MR. BRADLEY C IRWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1615 MAPLE LANE, ASHLAND, WI 54806
(715) 685-6010
(715) 682-0738
Mailing address
1615 MAPLE LANE, ASHLAND, WI 54806
(715) 685-6010
(715) 682-0738
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
52795
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104948020
—
MI
01
—
BI082468
BCBS
MI
Enumeration date
09/13/2006
Last updated
11/15/2024
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