Irvin, William M
Irvin, William M is an sole proprietor health care provider with primary practice located at 11477 Olde Cabin Rd Ste 210 , Saint Louis MO 63141-7129. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Psychiatry, which is considered as his primary health care specialty. Irvin, William M can be contacted via phone (314) 997-5208.Contact Information
Primary practice address
11477 Olde Cabin Rd Ste 210
Saint Louis MO 63141-7129
Phone: (314) 997-5208
Fax: (314) 997-5368
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Psychiatry | 2084P0805X | 2001010868 | Missouri |
Profile Details
| NPI number | 1942392931 |
|---|---|
| LBN Legal business name | Irvin, William M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 28th, 2006 |
| Last updated | Dec 17th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942392931 | NPPES |
| Missouri | MEDICAID | 205866304 | |
| Missouri | Other | 484342 | |
| Missouri | Other | 158049 | |
| Missouri | Other | 1530953 | |
| Missouri | Other | P00049380 |
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