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Individual
MIMI T VAN
Active
Individual
MIMI T VAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS13825
FL
207RG0100X
Gastroenterology Physician
Primary
34.017575
OH
207RG0100X
Gastroenterology Physician
7793
AZ
207RG0100X
Gastroenterology Physician
DO2023-1014
NM
Other
Enumeration date
09/17/2014
Last updated
12/09/2024
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