Individual
MICHAEL J MIRRO
Active
Individual
MICHAEL J MIRRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01025414A
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
01025414A
IN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
01025414A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000641091
ANTHEM
IN
05
—
0509079
—
OH
01
—
060070554
RR MEDICARE
IN
05
—
100138540
—
IN
01
—
P00782366
R.R. MEDICARE
IN
Enumeration date
08/15/2005
Last updated
04/21/2017
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