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NPI Code Detail

MEDICARE: THOMAS IRWIN

MEDICARE: THOMAS IRWIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAPRN.CNP.0028231OH

General Provider Information

NPI Number : 1417623265
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS IRWIN
Provider Business Mailing Address
First Line : 20050 HARVARD AVE STE 207
Second Line :
City : WARRENSVILLE HEIGHTS
State : OH
Zip : 44122-6800
Country : US
Telephone Number : 216-491-1010
Fax Number : 216-491-4824
Provider Business Practice Location Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-1397
Country : US
Telephone Number : 216-444-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2021
Last Update Date : 11/06/2021

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Directions to “ THOMAS IRWIN ” Practice Location

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