Mirkin, Irene R

Mirkin, Irene R is an individual health care provider with primary practice located at 7780 Elmwood Ave , Middleton WI 53562-5407. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Mirkin, Irene R can be contacted via phone (608) 417-3434.

Contact Information

Primary practice address
7780 Elmwood Ave Middleton WI 53562-5407
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 29156 Wisconsin

Profile Details

NPI number 1912949256
LBN Legal business name Mirkin, Irene R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Dec 14th, 2011 - about 13 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 1912949256 NPPES
Wisconsin MEDICAID 31391800
Wisconsin Other 1000324

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