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General NPI Number Information
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NPI Number | 1306110820
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Entity Type | Organization
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Legal Business Name | GILBERT R IRWIN MD PC
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Dates
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Enumeration Date | 03/01/2012
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Last Update Date | 03/20/2012
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Provider Practice Location Address
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Address Line | 9590 SURVEYOR COURT
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City | MANASSAS
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State | VA
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Zip | 20110-4406
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Country | US
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Telephone | 703-361-5116
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Fax |
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Provider Business Mailing Address
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Address Line | 9590 SURVEYOR COURT
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City | MANASSAS
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State | VA
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Zip | 20110-4406
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Country | US
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Telephone | 703-361-5116
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Fax |
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Authorized Official
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Title or Position | PREIDENT
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Name | DR. GILBERT RAYMOND IRWIN
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Credential | MD.
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Telephone | 703-361-5116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0101023931
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License Number State | VA
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