Provider Demographics
NPI:1932186624
Name:PARRA, IRMA P (MD)
Entity Type:Individual
Prefix:
First Name:IRMA
Middle Name:P
Last Name:PARRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49443-1848
Mailing Address - Country:US
Mailing Address - Phone:866-611-1512
Mailing Address - Fax:231-728-4789
Practice Address - Street 1:3587 HENRY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-6732
Practice Address - Country:US
Practice Address - Phone:231-672-6700
Practice Address - Fax:231-672-6749
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2021-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301072681207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4329139Medicaid
MI4329139Medicaid
MIH41390Medicare UPIN