Individual
DR. ILVA GENOVEVA IRIARTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5832
(843) 852-4100
Mailing address
125 E CHEVES ST, FLORENCE, SC 29506-2526
(843) 629-2494
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
LL34775
SC
2084P0800X
Psychiatry Physician
Primary
MD34775
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
06/12/2012
Last updated
10/30/2019
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