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Individual

DR. CHARLES MICHAEL IRVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
(724) 632-6312
Mailing address
1070 OLD NATIONAL PIKE, FREDERICKTOWN, PA 15333-2114
(724) 632-6801
(724) 632-6312

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002443L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
032094
HIGHMARK
PA
05
0984761
PA
05
1007288440027
PA
Enumeration date
12/16/2005
Last updated
04/29/2008
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