Provider Demographics
NPI:1659608412
Name:KING, IRINA G (MD)
Entity Type:Individual
Prefix:DR
First Name:IRINA
Middle Name:G
Last Name:KING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:IRINA
Other - Middle Name:G
Other - Last Name:ZADNEPRYANAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8303 PLATT RD
Mailing Address - Street 2:CENTER FOR FORENSIC PSYCHIATRY
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-9773
Mailing Address - Country:US
Mailing Address - Phone:734-429-2531
Mailing Address - Fax:
Practice Address - Street 1:8303 PLATT RD
Practice Address - Street 2:CENTER FOR FORENSIC PSYCHIATRY
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-9773
Practice Address - Country:US
Practice Address - Phone:734-429-2531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-14
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2408562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry