Individual
RICHARD LEWIS IRVING III
Active
Individual
RICHARD LEWIS IRVING III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHS, PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
MA052325
PA
363AS0400X
Surgical Physician Assistant
Primary
0010-00728
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0476PA
—
SC
Enumeration date
06/11/2006
Last updated
05/21/2014
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