Mietz, Michael Keith

Mietz, Michael Keith is an individual health care provider with primary practice located at 120 Hobart St , Utica NY 13501-4308. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Mietz, Michael Keith can be contacted via phone (315) 798-1149.

Contact Information

Primary practice address
120 Hobart St Utica NY 13501-4308
Phone: (315) 798-1149
Fax: (315) 734-3565
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 015421 New York

Profile Details

NPI number 1689944779
LBN Legal business name Mietz, Michael Keith
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2012
Last updated Apr 23rd, 2012 - about 12 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 1689944779 NPPES
New York MEDICAID 03419101

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