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:
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Health care specialties

SpecialtyCodeLicense #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 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942392931 NPPES
Missouri MEDICAID 205866304
Missouri Other 484342
Missouri Other 158049
Missouri Other 1530953
Missouri Other P00049380

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