Individual
DR. HENRY ANDREW IRVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
63245 SILVIS RD, BEND, OR 97701-9743
(458) 206-0145
Mailing address
63245 SILVIS RD, BEND, OR 97701-9743
(458) 206-0145
Taxonomy
Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
0101235094
VA
2085R0202X
Diagnostic Radiology Physician
Primary
0101235094
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127605
LICENSE
FL
Enumeration date
01/10/2006
Last updated
12/20/2018
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