Provider Demographics
NPI:1013544568
Name:PADUA, IRIE PAUL (MD)
Entity Type:Individual
Prefix:
First Name:IRIE
Middle Name:PAUL
Last Name:PADUA
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 1:290 E TOWN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4602
Mailing Address - Country:US
Mailing Address - Phone:614-788-5400
Mailing Address - Fax:614-788-5500
Practice Address - Street 1:200 S MANCHESTER AVE STE 835
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3213
Practice Address - Country:US
Practice Address - Phone:408-679-2611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-25
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty