Provider Demographics
NPI:1356309983
Name:WEBB, IRWIN ALLEN JR (MD)
Entity Type:Individual
Prefix:
First Name:IRWIN
Middle Name:ALLEN
Last Name:WEBB
Suffix:JR
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 1:201 E MARENGO ST
Mailing Address - Street 2:
Mailing Address - City:ST MICHAELS
Mailing Address - State:MD
Mailing Address - Zip Code:21663-2927
Mailing Address - Country:US
Mailing Address - Phone:410-745-6747
Mailing Address - Fax:
Practice Address - Street 1:8579 COMMERCE DR STE 106
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-7420
Practice Address - Country:US
Practice Address - Phone:410-819-0404
Practice Address - Fax:410-819-0751
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0040274207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD587001100Medicaid
E67366Medicare UPIN
MD600M950FMedicare PIN