Boone, Mira

Boone, Mira is an individual health care provider with primary practice located at 1534 W D St , North Wilkesboro NC 28659-3528. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Boone, Mira can be contacted via phone (336) 667-4178.

Contact Information

Primary practice address
1534 W D St North Wilkesboro NC 28659-3528
Phone: (336) 667-4178
Fax: (336) 667-0938
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 2008-00571 North Carolina
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 2008-00571 North Carolina
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 2008-00571 North Carolina

Profile Details

NPI number 1053511642
LBN Legal business name Boone, Mira
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2007
Last updated May 8th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053511642 NPPES
North Carolina MEDICAID 5909947

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