Mirian, Mirfattah

Mirian, Mirfattah is an individual health care provider with primary practice located at 721 S Long Dr , Rockingham NC 28379-4315. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Mirian, Mirfattah can be contacted via phone (910) 997-3779.

Contact Information

Primary practice address
721 S Long Dr Rockingham NC 28379-4315
Phone: (910) 997-3779
Fax: (910) 997-7433
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 250 North Carolina
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 250 North Carolina

Profile Details

NPI number 1538285069
LBN Legal business name Mirian, Mirfattah
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2007
Last updated Feb 25th, 2008 - about 16 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 1538285069 NPPES
North Carolina MEDICAID 890812A

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