Provider Demographics
NPI:1851580120
Name:ISAAC, IRENE C (PA-C)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:C
Last Name:ISAAC
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:1701 WESTCHESTER DR
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7008
Mailing Address - Country:US
Mailing Address - Phone:336-802-2536
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:1701 WESTCHESTER DR
Practice Address - Street 2:SUITE 850
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7008
Practice Address - Country:US
Practice Address - Phone:336-802-2536
Practice Address - Fax:336-802-2534
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2014-05-02
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1851580120OtherBCBS-NC
NC1851580120Medicaid
NC2762523Medicare PIN
NCNC3837BMedicare PIN