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Individual

DAVID W. IRVINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
621 S NEW BALLAS RD, SUITE 5015-B, SAINT LOUIS, MO 63141-8232
(314) 567-5850
(314) 567-9169
Mailing address
PO BOX 843438, KANSAS CITY, MO 64184-3438
(314) 567-5850
(314) 567-9169

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
106129
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000684662
ANTHEM BCBS
MO
01
1386681138
HUMANA
MO
05
209074004
MO
01
273406555
MULTIPLAN/PHCS
MO
01
561508
HEALTHLINK
MO
01
615723400
DEPARTMENT OF LABOR
MO
01
7308358
AETNA
MO
Enumeration date
06/01/2006
Last updated
01/19/2011
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