GLENN EDGAR IRWIN JR. (NPI# 1093793598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093793598 |
| Entity Type | Individual |
| Full Name | GLENN EDGAR IRWIN JR. |
| Credential | MD |
| Practice Address |
900 Chestnut Street Ext Ste A Bradford PA 16701 |
| Mailing Address |
900 Chestnut Street Ext Ste A Bradford PA 16701-2298 |
| Practice Telephone | 8148172870 |
| Practice Fax Number | 8143688041 |
| Mailing Telephone | 8148172870 |
| Mailing Fax Number | 8143688041 |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2019-01-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | MD028763E | PA | Allopathic & Osteopathic Physicians |
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
MD028763E | PA | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | MD028763E | PA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 195 Pleasant St Unit 5, Bradford, PA 167011081 | 8143625701 | 8143625702 |
| 821 N Nellis Blvd, Las Vegas, NV 891105339 | 7024384003 | 7024380555 |
| Street Address |
900 CHESTNUT STREET EXT STE A |
| City | BRADFORD |
| State | PA |
| Zip Code | 16701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093286031 | Irwin Medical Associates Pllc | Family Medicine | 900 Chestnut Street Ext Ste A, Bradford, PA 16701-2298 | 2018-12-17 |
| 1689763351 | Nicole Ackley | Physician Assistant | 900 Chestnut Street Ext Ste A, Bradford, PA 16701-2298 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417557232 | Allison Keller | Pharmacist | 50 Foster Brook Bvld, Bradford, PA 16701 | 2020-10-30 |
| 1043767734 | Asim Makhdom | Orthopaedic Surgery | 195 Pleasant Street, Suite 5, Bradford, PA 16701 | 2016-09-09 |
| 1821435322 | Family Wellness Chiropractic Inc. | Chiropractor | 536 East Main Street, Bradford, PA 16701 | 2013-05-24 |
| 1285983973 | Ashley Lynn Disney | Physician Assistant | 181 Interstate Parkway, Bradford, PA 16701 | 2012-09-10 |
| 1760799563 | Paulinus Joseph Sorg | Physical Therapist | 24 West Washington Street, Bradford, PA 16701 | 2010-09-01 |
| 1215194535 | Jill Lorryn Campbell | Speech-Language Pathologist | 412 Langmaid Ln, Bradford, PA 16701 | 2008-05-22 |
| 1689890048 | Brian Alan Volpe | Dentist | 84 Boylston St, Bradford, PA 16701 | 2007-04-17 |
| 1366564098 | Lori Ann Peterson | Speech-Language Pathologist | 110 Campus Drive, Bradford, PA 16701 | 2007-04-04 |
| 1760507776 | Bruce Lee Sitler | Physical Therapist | Bradford Ecumenical Home, 100 St. Francis Drive, Bradford, PA 16701 | 2007-03-20 |
| 1932294451 | Nancy Marie Fuhrman | Chiropractor | 28 Davis Street, Union Square, Bradford, PA 16701 | 2006-10-03 |
| Find all providers in zip 16701 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093286031 | Irwin Medical Associates Pllc | Family Medicine | 900 Chestnut Street Ext Ste A, Bradford, PA 16701-2298 | 2018-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972036515 | Hussein Safa | Family Medicine | 1300 W Tabor Rd Bldg 1, Philadelphia, PA 19141 | 2017-04-11 |
| 1639625809 | Gina Slobogin | Family Medicine | 400 Cherry Tree Rd, Upper Chichester, PA 19014-2406 | 2016-08-28 |
| 1134536238 | Kristina Marie Newcomer | Family Medicine | 496 Shelleys Ln, Etters, PA 17319-9412 | 2014-07-21 |
| 1811317886 | Paul Nweze Madubuonwu | Family Medicine | 4 Foster Plz, 501 Holiday Drive, Pittsburgh, PA 15220-2749 | 2014-04-17 |
| 1861735037 | Harold David Thomas Jr. | Family Medicine | 104 Brookhaven Dr, Aliquippa, PA 15001-1565 | 2013-04-05 |
| 1275896383 | Louis Bell | Family Medicine | 322 Linden Drive, Elkins Park, PA 19027-1342 | 2012-06-22 |
| 1538433040 | Ramona Chube, M.d.,p.c. | Family Medicine | 7700-a Stenton Ave, Philadelphia, PA 19118-3103 | 2012-03-01 |
| 1578835799 | Gordon Thomas Fletcher | Family Medicine | 128 Guillard Rd, Prospect, PA 16052-2702 | 2012-02-03 |
| 1548568157 | Philip Edward Shoaf | Family Medicine | 4074 Market St, Birmingham, PA 16686-5004 | 2011-03-06 |
| 1316257884 | Theodore P. Burger | Family Medicine | 3370 Woodbridge Cir, Bethlehem, PA 18017-1736 | 2010-10-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.