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General NPI Number Information
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NPI Number | 1730560343
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Entity Type | Individual
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Provider Name | COLIN IRELAND D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2015
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 1 GENESYS PKWY
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City | GRAND BLANC
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State | MI
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Zip | 48439-8065
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Country | US
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Telephone | 714-686-2633
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Fax |
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Provider Business Mailing Address
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Address Line | 2646 ANDOVER AVE APT B
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City | FULLERTON
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State | CA
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Zip | 92831-5700
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Country | US
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Telephone | 714-686-2633
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 5315071195
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DO01065
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 17651
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 5101021872
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License Number State | MI
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