Provider Demographics
NPI:1841491263
Name:JUREC IRVING, ANNA MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARIA
Last Name:JUREC IRVING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MARIA
Other - Last Name:JUREC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:19 WORTHY CT
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-2751
Mailing Address - Country:US
Mailing Address - Phone:314-488-5274
Mailing Address - Fax:636-825-2178
Practice Address - Street 1:19 WORTHY CT
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-2751
Practice Address - Country:US
Practice Address - Phone:314-488-5274
Practice Address - Fax:636-825-2178
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004011262390200000X
MO20080137512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program