Provider Demographics
NPI:1841298486
Name:SPIRN, IRWIN (MD)
Entity type:Individual
Prefix:
First Name:IRWIN
Middle Name:
Last Name:SPIRN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 MARLTON PIKE E
Mailing Address - Street 2:BUILDING O-77
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2150
Mailing Address - Country:US
Mailing Address - Phone:856-424-4525
Mailing Address - Fax:856-424-9545
Practice Address - Street 1:1930 MARLTON PIKE E
Practice Address - Street 2:BUILDING O-77
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2150
Practice Address - Country:US
Practice Address - Phone:856-424-4525
Practice Address - Fax:856-424-9545
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03710500207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0955108Medicaid
C60102Medicare UPIN
NJ0955108Medicaid