Individual
JOHN RICHARD IREDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
4119 CAPITOL ST, DURHAM, NC 27704-2153
(919) 477-0333
(919) 477-9389
Mailing address
4119 CAPITOL ST, DURHAM, NC 27704-2153
(919) 477-9333
(919) 477-9389
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
51
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08092
BCBS OF NC PROVIDER NUMBE
NC
05
—
8908092
—
NC
Enumeration date
09/27/2005
Last updated
05/04/2011
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