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Individual

MICHAEL IRELAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
3535 MARKET ST STE 1230, PHILADELPHIA, PA 19104-3309
(610) 892-3800
Mailing address
3005 GRAYS FERRY AVE UNIT 3809, PHILADELPHIA, PA 19146-5300
(215) 609-2701

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP024157
PA

Other

Enumeration date
08/04/2021
Last updated
08/04/2021
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