Individual
MELISSA M IRWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
335 GLESSNER AVE, MANSFIELD, OH 44903-2269
(419) 522-2734
(419) 522-2240
Mailing address
5450 FRANTZ RD STE 360, DUBLIN, OH 43016-4141
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.002355
OH
363AS0400X
Surgical Physician Assistant
50002355
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000388747
ANTHEM
OH
05
—
0069995
—
OH
Enumeration date
09/13/2006
Last updated
06/28/2019
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