Individual
IZZA MIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1000 1ST DR NW, AUSTIN, MN 55912-2941
(507) 433-7351
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-5412
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
72609
MN
207R00000X
Internal Medicine Physician
Primary
H0100219
MD
207R00000X
Internal Medicine Physician
OT017043
PA
Other
Enumeration date
05/12/2016
Last updated
09/18/2024
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